Santa Barbara City College Study Abroad Program Paris, France June 24 through July 24, 2018 Application Procedure

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1 Santa Barbara City College Study Abroad Program Paris, France June 24 through July 24, 2018 Application Procedure Deadline for application: April 16, 2018 Apply early as the number of places in the program is limited and the program may fill before the deadline. If the program is full before the deadline, acceptance is not guaranteed. Applications may be accepted after the deadline, if space is available. This application is for the participation in the Paris Summer 2018 Study Abroad Program only. To apply to the program, please submit the following: Completed and signed application form. If you change addresses after submitting your application, please provide the Study Abroad Office with your new address. Responses to questions (typed or printed clearly) Please answer the questions provided on the application form. Two 2x2 photos. Two recent color photos that are a full-face view are acceptable. Please trim them to fit. Pictures need to clearly identify you. Pictures from a passport service or photo booth are acceptable. Print your name with a ballpoint pen on the back of each picture and staple the pictures to the application form. Completed Student Conduct Release Form. The top of the Student Conduct Release Form is to be filled out by you and taken to the Office of Students, Dean of Student Affairs, at the institution you are currently attending. If you currently attend SBCC, please take the form to the Office of Student Support Services in the Student Services building, Second Floor, Room SS-260. The bottom of the form will be completed by the appropriate student official and returned to the SBCC Study Abroad Office. Your acceptance to the program is not final until the form is returned to the Study Abroad Office. $250 non-refundable first payment. Payment may be made by check or money order made out to ACCENT. Please put your check or money order in an envelope and staple it to your application. We do not accept cash. Submit your application Applications must be complete and include the application form, answers to the questions, photos, and application fee. The Student Conduct Form must be received by the Study Abroad Office before final approval and acceptance is not guaranteed until receipt of all materials. Submit by mail to: Santa Barbara City College Study Abroad Office 721 Cliff Drive Santa Barbara, CA Drop application off at: Santa Barbara City College International Education Center, Room 1 (SBCC Main Campus, below the Humanities Building) Interview. After receipt of your application, you will be contacted to arrange an interview with the program director. For applicants not living in the Santa Barbara, interviews can be completed by phone. Notification of Acceptance by SBCC. After review of your application and the interview, the Study Abroad Office will notify you of your acceptance into the program by to your pipeline or if you are not currently a SBCC student to your primary provided in the application. Communication. The SBCC Study Abroad Office and ACCENT will communicate with you by and regular mail. WE will be using your SBCC Pipeline for primary communication. If you change your mailing address or , please notify the Study Abroad Office immediately by sending your new information to nwalther@pipeline.sbcc.edu. ACCENT 870 Market Street Suite 1026 San Francisco, CA Phone: (800) Fax: (415) SBCC Study Abroad Programs 721 Cliff Drive International Education Room 1 Santa Barbara, CA Phone: (805) Nwalther@pipeline.sbcc.edu Study Abroad Website: All Statements made on this sheet and distributed generally to prospective or accepted participants shall be informational only and should not be interpreted as being contractual for any purpose.

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3 Santa Barbara City College Study Abroad Program Paris, France June 24 through July 24, 2018 Application Form Legal Name: Last First Middle (as it appears on passport) K No: Your K number is under the bar code on your SBCC student ID card) Current Address: Phone # Please provide number best to reach you during the application process & prior to the program start 1. Using a ball point pen, print your name and SBCC PARIS SU18 on the back of the photos. 2. Staple two 2 x 2 size photos here Alternative Address (after current semester ends.) Alternative Phone # (after current semester ends.) Date of Birth: Are you planning on doing the group flight? Yes No Which Institution do you currently attend? SBCC Pipeline Address: Please print CLEARLY this is our primary form of communication with you. Secondary Address: Please print CLEARLY this is our alternative form of communication with you until you have a Pipeline address Citizenship (country) Ethnicity Academic Major Please indicate the best times to reach you at the current phone: Please list the names of two people who may be contacted in the event of an emergency. These people may be parents, guardians, relatives, or close friends. Name: Address: City, State, Zip: Phone: Relationship: I hereby authorize SBCC representatives to contact and discuss with the persons listed above my status in the study abroad program. I further authorize Carola Smith, Senior Director of International Programs, to review my student conduct file. Check here if you would like to request special accommodations. If you have a disability for which you will be seeking special accommodations abroad, please contact the SBCC Disabled Students Programs and Services (DSPS) specialist immediately to begin discussions about reasonable accommodations. Phone: (805) ext or (805) or dspshelp@sbcc.edu. The office is located at the Student Services Building SS-160. The process to reach agreement on reasonable accommodations must take place before you leave the US. Students who disclose needs at the last minute or who require accommodations that cannot be made available in the host country may be advised to postpone participation or consider another program.

4 Do you have a medical condition that may prevent you from being able to function in the following or situations or to participate in the following activities? Walking on uneven surfaces for at least two miles Climbing several flights of stairs Sitting in buses/ trains/ airplanes for extended periods of time Being able to adjust to substantially different diets Being able to function at times in extremely hot or adverse weather conditions If you checked any of the activities above, please note your medical condition. The information will be shred with our Health and Wellness Program. If you have questions regarding your health as it relates to your ability to participate in the study abroad program, please consult with your physician. I have carefully read the brochure for the SBCC Semester in Paris Program and wish to apply. I agree to the terms and conditions stated in the program brochure, including the payment and refund policies. I understand that if there are any changes in the terms and conditions, ACCENT will notify me in writing. I shall be the client of ACCENT for all purposes. Any applicable refunds will be returned to me regardless of the source of payment. Required Legal Documents If I do not complete and return the required Study Abroad legal documents by the stated due date, I may be cancelled from the program and held responsible for any cancellation penalties, which may apply. Responses to Questions. On a separate sheet of paper, please answer the following questions. You may either type or clearly print your responses. Please limit all your answers to all four questions to 1 2 pages. 1. What are 5 things that you are looking forward to about studying abroad? 2. What are 5 challenges that currently worry you the most about going overseas? 3. How do you think the values and perspectives of the host country will be different from your own cultural values? 4. How do you think you will be perceived by the people in the host country based on your nationality and cultural heritage?

5 Santa Barbara City College Dean of Students Conduct Release Form To the SBCC Study Abroad Applicant: Please complete the top part of this form. Give this form and a pre-stamped and pre-addressed envelope to Santa Barbara City College, Study Abroad Programs, 721 Cliff Drive, Santa Barbara, CA 93109, to the Dean of Students at the college or university you are currently attending. Ask the Dean to complete the bottom part of the form, sign, seal, and to return it directly to Santa Barbara City College Study Abroad Programs in the envelope that you provide. Name: Last First Middle (if you are a SBCC student) K# Current Address: Phone # Paris, France Summer 2018 Program Which academic institution do you currently attend? Dates of attendance at your current institution: From to I hereby consent to the Dean of the college I am currently attending to furnish Santa Barbara City College with the information on the form below and I hereby waive my right of access to any statements by said Dean evaluating me and my activities. Signature: To the Dean: The student named above has applied to participate in a study abroad program at Santa Barbara City College. Thank you for taking the time to complete this form and returning it as soon as possible to Santa Barbara City College, Study Abroad Programs, 721 Cliff Drive, Santa Barbara, CA Has this student been subject to any disciplinary actions? Yes No If yes, please explain. Are any disciplinary charges pending? Yes No If yes, please explain. Has this student been expelled, suspended, placed on probation, required to withdraw, or given a reprimand or warning? Yes No If yes, please explain. Is this student eligible to re-enroll at your college? Yes No Conditionally If No or conditionally, please explain. Any additional comments you may wish to make regarding this student. Signature Name (Please print) Title Institution Phone