INFORMATION AND CHECKLIST This application form filled out completely. (Include Affidavit of Agreement.. and Acknowledgement of Risk Forms) A letter of intent stating your reasons for wanting to take the class and your experiences or interests in foreign cultures. NOTE: Your letter must be attached to this application A completed recommendation from a faculty member who knows you well. NOTE: The recommendation form from this application MUST be used A copy of the information page of your valid passport OR a completed passport application form showing the date of application A copy of your college transcripts. (downloaded from Oasis is fine.) Application Deadline for SUMMER 2014 is March 17, 2014 Submit your application to: Laura Bauknecht or Liz Chilsen Photography Department Columbia College Chicago 600 South Michigan Avenue, 12th Floor Chicago, IL 60605 For information or questions contact: Laura Bauknecht: lbauknecht@colum.edu Liz Chilsen: echilsen@colum.edu 23-2717 (UG) AND 23-6792 (GR) Photography Studies Abroad: The Netherlands Tentative Dates on-site June 1 to June 16, 2014 23-2718 (UG) AND 23-6791 (GR) Photography Studies Abroad: Southeast Asia Tentative Dates on-site June 6 to June 27, 2014 Acceptance based on student s submission of application, letter of intent & faculty recommendation. Pre-requisite Foundations of Photo, 23-1111, or comparable experience. Students who have not taken 23-1111, contact Liz Chilsen echilsen@colum.edu NOTE: Adherence to and professionalism regarding deadlines and other requirements is required. Failure to comply may jeopardize the applicant s ability to participate in the program. Page 1 of 6
IMPORTANT DATES Now: Feb 1 March 17, 2014: March 10, 2014: March 17, 2014: April 1, 2014: April 7, 2014: April 14, 2014: April 21: May 1, 2014: May 9, 2014: Apply for your passport if you do not already have one. Check the date on your current passport: o Passport MUST BE valid AT LEAST until January 1, 2015. Research your options for Study Abroad Meet with your advisor Pre-requisite 23-1111. o See echilsen@colum.edu if you have not taken this course. Review your financing Student Financial Services Meet with your faculty advisor to discuss your study abroad options. Application distributed and available via download on dept website. Deadline for submission of completed application. Follow all instructions carefully. Student notifications for acceptance to class. Accepted students will be authorized to register into the class. Wait-listed students will be given information about any applicable deadlines. Summer Registration begins. Students must also register for the course. Initial Deposit DUE on program Fees (payable via CCC Cashier) Students accepted to the class must pay their deposit by this date. Students must be registered for the course by this date. College 45-Day Cancellation Deadline: Course may be cancelled due to insufficient enrollment. Visa Application DUE. For SE Asia NOTE: if you intend to travel to other countries after the class ends, you must also apply for any needed visas by this date. After this date, no refund can be guaranteed. Any outstanding forms must be submitted to Photo Office. CANCELLATION POLICY: Once a student has been accepted to the class, the student will be cleared to register and must pay the initial $1000 deposit on program fees per the deadlines above. Due to advance booking fees incurred by the program, a $500 cancelation fee will be charged for any student-initiated cancellations after May 1, 2014. After this date, a partial refund may be given, but this will be based upon costs actually incurred by the program. Please note that, due to the program s booking obligations, after May 15, 2014, no refund can be guaranteed for cancellations for any reason. Program fees cover the following: airfare, hotel, most meals, museum and gallery entry fees as needed, and travel within country during the dates of the course. Tuition costs are in addition to Program Fees and must be paid separately. Page 2 of 6
STUDENT INFORMATION NAME As it appears on your passport OASIS ID Alternate email * Cell Phone Number Permanent Address City State Zip Campus Address If Different City State Zip PASSPORT NUMBER Passport Issue Date Date of Birth Passport Issue Office Place of Birth Citizenship EMERGENCY CONTACT INFORMATION PROVIDE TWO CONTACT NAME Relationship Phone Number Email address City and State CONTACT NAME Relationship Phone Number Email address City and State Page 3 of 6
LETTER OF INTENT completed by student and attached The Photography Studies Abroad classes will be competitive. 12 students will be admitted. The primary criterion for selection will be: 1) The quality of your application including the letter of intent. 2) Your prerequisites. 3) Academic standing. Students not accepted to this year s course are encouraged to apply next year. For your letter of intent, please address the 5 areas listed below. Please write between 100 and 200 words in response to EACH of the following. 1) Why do you want to take this course? 2) What prerequisites and /or previous experiences with Interntional cultures do you have? 3) How will this course enhance your learning experience at Columbia? 4) How will it impact your future career? 5) Add any information (up to ½ page if needed) you think might help us in the selection. Note: The letter of intent must be attached to your completed application, and submitted by March 17, 2014 Page 4 of 6
LETTER OF RECOMMENDATION instructions to recommender: This form should be filled out by a faculty member, department chair, or director of a program of study who is most familiar with the student's academic and artistic achievements. Please retain a copy of the completed recommendation for your records. Send original in a sealed envelope and signed across the back to: Laura Bauknecht Photography Department Columbia College Chicago 600 S. Michigan Ave, 12 th FL Chicago IL 60605 OR email to Laura Bauknecht: lbauknecht@colum.edu Name of recommender (please print) Name of student (please print): How long have you known the applicant? Capacity in which you know applicant Department of Recommender Phone: Email: Please rate the student on each of the following areas. Please indicate your rank on a scale of 1-5 in which 5 is outstanding accomplishment and 1 is unacceptable. Indicate by circling the number. 1. The applicant attends class regularly and came to class on time and prepared. 2. The applicant exhibits a high degree of maturity, motivation and readiness for an international exchange program. 3. The applicant engages actively in classroom discussions and coursework. 4. In class discussions, the candidate offers insightful questions, constructive suggestions and comments that indicate preparedness. 5. The candidate possesses unique talents, abilities and qualifications that make them a good selection to represent Columbia College Chicago internationally. 6. Please include on the reverse, if you would like, any additional comments or information relevant to evaluating this candidate's application to participate in an international exchange program and how they would benefit from this program. Summary: I recommend this candidate without reservation with reservation Signature: Date: Columbia College Chicago is an affirmative action, equal opportunity institution. Page 5 of 6
Student must also complete and attach the following two documents to their completed application: Affidavit Of Agreement And Acceptance Regarding Illegal Drug Use And Possession Acknowledgement Of Risks And Release Of Responsibility Page 6 of 6
Academic Initiatives and International Programs AFFIDAVIT OF AGREEMENT AND ACCEPTANCE REGARDING ILLEGAL DRUG USE AND POSSESSION Name: Oasis ID# : Program Name and Location: Program Term and Year: Many US students and travelers have suffered greatly as a result of drug-related incidents while traveling outside the US. Remember that, as a US citizen in a foreign country, you are subject to the laws of that country. The US Embassy or Consulate cannot be expected to obtain release from jail for a US citizen; the officials there can only aid in obtaining legal assistance. Illegal activities involving the possession and/or use of illicit drugs place not only the individual but also the entire group and the program in jeopardy. Therefore, every study abroad participant must agree to and accept the conditions of participation as stated below in regard to illegal drug use and/or drug possession: Consequences related to illegal drug use and/or drug possession include but are not limited to: Immediate expulsion from the program Total forfeiture of all fees and monies paid to the program Loss of all course/academic credit Prohibition from participating in future Columbia College Chicago programs abroad Program participants must take responsibility, both individually and as a group, for assuring that this policy regarding illegal drug use and drug possession is strictly observed. I have read all of the above and understand that the use or possession of any quantity of marijuana, cocaine, heroin, or any drug or intoxicant deemed illegal in any of the countries through which I travel to reach my study abroad destination and return from there, is strictly prohibited through the duration of the program in which I am participating. I understand that it is my responsibility to know and abide by the laws of the country in which I am present as well as those countries through which I travel while participating in the program. I have read the consequences for violation stated above and agree to and accept all of the conditions stated above. Signature of Participant Date Parental Consent (Required if student is under 18 years of age at beginning of program) The undersigned parent or legal guardian of the above-named student, a minor, hereby consents to the participation of said student in the study abroad program named above, subject to the warnings stated above. Signature of Parent/Guardian Date Columbia College Chicago International Programs 618 S Michigan, First Floor Chicago, IL 60605 P 312.369.7726 aiipoffice@colum.edu
Academic Initiatives and International Programs ACKNOWLEDGEMENT OF RISKS AND RELEASE OF RESPONSIBILITY Name: Oasis ID # : Program Name and Location: Program Term and Year: Columbia College Chicago offers students the opportunity to enroll in overseas study programs, some operated by different education institutions. Certain potential risks to personal health and safety are associated with international travel and residence in a foreign country. You should not participate in a study abroad program unless you understand and are willing to accept the associated risks. Columbia College Chicago cannot guarantee the health and safety of participants in a study abroad program or eliminate all risks from study abroad environments. Please read, sign and return this form before your program of study begins. Students who fail to return this form will not be allowed to participate in any programs. I understand that there are certain risks associated with international travel and residence in a foreign country and that Columbia College Chicago and its staff cannot control these risks. I understand that these risks may include exposure to potentially serious health and safety hazards such as: transportation accidents, storms, floods, earthquakes, and other natural disasters; infectious diseases, inadequate medical care, remote access to medical treatment; armed insurrections; and terrorist activities. I understand that Columbia College Chicago is not in a position to guarantee my personal health or safety during my participation in a study abroad program. I understand and agree to abide by the applicable rules and regulations of the study abroad program and the laws of the countries in which I will be present or travel through while participating in the study abroad program. I understand and hereby acknowledge that I assume all risks incurred by my participation in a program offered through Columbia College Chicago or other program. I understand that should I decide to leave the study abroad program before the end of the semester/program for any reason, including but not limited to security concerns, there is no guarantee that I will receive credit or a refund of tuition or any other fees paid for study abroad program. In consideration of being allowed to enroll and participate in a study abroad program, the undersigned hereby agrees to release, hold harmless and indemnify Columbia College Chicago, its Board of Trustees, affiliates, officers, agents and employees from any and all claims arising out of or in any way connected with the study abroad program and the undersigned s participation in the program, including, but not limited to, the outlined items above. Signature of Participant Date Parental Consent (Required if student is under 18 years of age at beginning of program) The undersigned parent or legal guardian of the above-named student, a minor, hereby consents to the participation of said student in the study abroad program named above, subject to the warnings stated above. Signature of Parent/Guardian Date Columbia College Chicago International Programs 618 S Michigan, First Floor Chicago, IL 60605 P 312.369.7726 aiipoffice@colum.edu