Nicholls State University College of Business Administration 2015 Study Abroad in China Application

Transcription

1 Rev. 10/17/14 Nicholls State University College of Business Administration 2015 Study Abroad in China Application Section I- Participant Data: First Name M. I. Last Name ID # Classification Date of Birth Mailing Address City State & Zip Address (include a permanent one), Permanent Nicholls Only when Applicable. Home Phone Work Phone In case of emergency contact Cell Phone Relationship Home Phone Work Phone Cell Phone Please list any pertinent medical information (allergies, pregnancy, medical conditions, etc.) Please notify the Faculty Coordinator of ANY changes to the above information IMMEDIATELY. Section II - Program Data: Study Abroad in China Full Program Cost (does not include passport) $4,499 (includes $500 nonrefundable deposit) Section III- Payments: The number of students that can participate in Study Abroad Programs is limited. Early application with payment of your non-refundable deposit is advised. Approval of your Application to Participate in Study Abroad and acceptance of your $500 non-refundable deposit will reserve your place in your Study Abroad Program. This reservation is made with the understanding that you are committed to full payment of program costs and full participation in the program as stipulated in program brochures, handbooks, and course syllabi and other materials. $500 nonrefundable deposit is due December 12, Submit payment to the Dean s Office (White 106) with the payment memo (payment memos are the last three pages of the application packet) from the Faculty Coordinator. A receipt for payment must be submitted with your application. Late enrollment after December 12, 2014 will be accepted with a non-refundable $250 surcharge depending on availability. Two payment installments are due. First installment of $1,500 is due January 30, 2015 (submit to the Dean s Office White 106). Second installment of $2,499 is due February 27, 2015 (Submit to Fee Collections). Receipt of payment must be presented to the Faculty Coordinator. Documented anticipated financial aid will be considered payment. In the event a student's anticipated financial aid becomes unavailable for any reason, including suspension of awards because of withdrawal from the Study Abroad program, the student will be responsible for all Study Abroad fees as indicated in this form and other program materials. Students who sign up after the group airfare has been purchased may have an airfare surcharge if the fare has increased. Note: Students who owe payments to the University will not be eligible to participate in the Study Abroad Program until all debts have been cleared, or the Controller's Office certifies that payment arrangements have been made.

2 Section IV - Refunds: Students will be notified of program cancellations by March 6, Students whose written withdrawal is received by the Faculty Coordinator by January 30, 2015, 4:30PM, will receive full refund of payments made minus $500 non-refundable deposit. Those who enrolled after December 12, 2014 will also forfeit the $250 surcharge. Students who have made full payment and whose written withdrawal is received by the Faculty Coordinator after January 30, 2015, 4:30PM, will be refunded $2,499. No refunds will be made for withdrawals received by the Faculty Coordinator after February 6, 2015, 4:30PM. No refunds will be made for students that withdraw from a program in progress before its completion. No refunds will be made for students that are scheduled to participate in a program but fail to attend. In case of withdrawals, Financial Aid arrangements made to cover Study Abroad costs will be suspended. In the event a student's anticipated financial aid becomes unavailable for any reason, including suspension of awards because of withdrawal from the Study Abroad program, the student will be responsible for all Study Abroad fees as indicated in the application form and other program materials. Section V - Stipulations: College of Business Administration Study Abroad programs are only available to registered Nicholls juniors, seniors, and graduate students and in good academic standing (students on academic probation or suspension are not eligible to participate). Course pre- and co-requisites must be met. Acceptance of your application and non-refundable deposit does NOT mean approval to participate in the Study Abroad program. The Faculty Coordinator will notify you in writing of your approval to participate, non-approval to participate, or waiting-list status. Nicholls State University, hereinafter referred to as Nicholls, and its agents, directors, and officers, act only as agents in arrangements made for this program. Neither Nicholls nor its agents, directors, or officers shall be liable for any injury, death of persons, loss, damage or accident, delays or expenses arising from Acts of God, dangerous incident on land or sea, fire, breakdowns of machinery or equipment, acts of government or other authorities, wars, civil disturbances, strikes, riots, thefts, pilferage, epidemics, quarantines, changes in itinerary, weather, sickness, or from any act of omission of any individual, firm or corporation furnishing transportation, sightseeing, hotel accommodations, or any other services in connection with the tours, site visits, or other activities related to Nicholls's study abroad programs. The right is reserved to amend the advertised itinerary whenever transportation schedules or other factors make this necessary or advisable. I have read and understand the payment and refund schedules and stipulations contained in this form. I further understand that, if I intend to use Financial Aid as my method of payment for this program, I am fully responsible for payment to this program as outlined above in the event my anticipated financial aid becomes unavailable for any reason. I hereby affirm that to the best of my knowledge all information furnished on this form is complete and accurate. I understand that withholding information requested and giving false information may make me ineligible for enrollment in Nicholls's study abroad programs. It is my intention to participate in the Nicholls Study Abroad Program as outlined above. Signed Date

3 Passport Information Sheet Please complete this form asap, no later than January 30, 2015; this information is required for air purchase. A copy of your passport information page is also required and needed for hotel reservations. Family Name: Given Names: Date of Birth: Gender: Male; Female Passport Number: Passport Expiration Date: Nationality: Make sure to double check that your information is correctly entered.

4 College of Business Administration Department of Accounting and Information Systems P.O. Box 2015 Thibodaux, LA phone fax China Payment Memo 1 TO: Dean s Office (White 106) FROM: En Mao SUBJECT: Study Abroad in China Program payment DATE: Please deposit to the College of Business Administration Study Abroad in China Program - NSU Foundation account. A receipt is required. Student Name ID # Submit payment at the Dean s office (White 106) $500 Due by Dec 12 th, 2014 Cash or check (payable to NSU Foundation)

5 College of Business Administration Department of Accounting and Information Systems P.O. Box 2015 Thibodaux, LA phone fax China Payment Memo 2 TO: Dean s Office (White 106) FROM: En Mao SUBJECT: Study Abroad in China Program payment DATE: Please deposit to the College of Business Administration Study Abroad in China Program - NSU Foundation account. A receipt is required. Student Name ID # Submit payment at the Dean s office (White 106) $1,500 Due by January 30th, 2015 Cash or check (payable to NSU Foundation)

6 College of Business Administration Department of Accounting and Information Systems P.O. Box 2015 Thibodaux, LA phone fax China Payment Memo 3 TO: Fee Collections FROM: En Mao SUBJECT: Study Abroad in China Program payment DATE: Please deposit to the College of Business Administration Study Abroad in China Program account # A receipt is required. Student Name ID # Submit payment at Fee Collections $2,499 by February 27 th, 2015 Cash, check (payable to Nicholls State University), or credit card