Application Form 2019 Please remember to include 2 passport-size photos with your name. Personal Information (PLEASE PRINT CLEARLY USING BLOCK LETTERS) First Name Last Name Student ID Pass-port photo 1 Address City State/County Postal Code (ZIP) Country Nationality Telephone Email Pass-port photo 2 Date of birth: Passport number: Emergency contact info: Academic Information (PLEASE PRINT CLEARLY USING BLOCK LETTERS) FOR STUDENTS ONLY _ Name of your most current Spanish professor at UH His/her phone number and/or email address _ Number of years you ve studied Spanish at the university Level of Spanish you ve most recently completed GPA Level of Spanish (please check one) o Beginner. Fair understanding of basics; can speak in simple statements. o Intermediate. Can write short sentences and participate in a basic conversation. o Advanced. Can write complex sentences and participate in all conversations. o Superior. Your Spanish both in written content and in spoken content and accent - is nearly like a native s. Accommodation Data (PLEASE PRINT CLEARLY USING BLOCK LETTERS) FOR STUDENTS ONLY Please list here above any special dietary needs, such as vegetarian or food allergies (please specify). Do you have other allergies (cigarette smoke, pets, etc.)? Please specify here above. If you are taking any medication, please specify here above. Additional medical information? Normally students live in pairs or triples. If you would like to share a host-family room with a friend (same sex only), please write his/her name here above.
Cadiz 2019 Summer Program PRICING: $4500.00 Tentative Program fee (Final cost will be determined in February 2019) Learning Abroad offers International Education Fee Scholarship (IEFS). The deadline for applications is September 30, 2018 (Fall). Students can also apply for Summer 2019 programs during the Spring 2019 IEFS cycle. Eligibility criteria: Must have completed 12 UH credit hours*, have a minimum 2.5 GPA*, and be in good academic standing. Must NOT have received the IEFS before. *Credit hours and GPA at time of application. First-semester and new transfer students are not eligible to apply during their first semester at UH. The airfare is not included. Students should make their own arrangements to arrive in Madrid by Saturday June 1 nd, 2019 in the morning. The Price includes: Overnight stay in Madrid on June 1 st with a cultural visit. Bus transportation to Cádiz and back to Madrid on Friday June 28. Overnight stay in Madrid on June 28 th Visit to Córdoba on Sunday June 2 nd Housing with a family, 3 meals included, laundry All class materials University certificate MundoLengua tutoring Orientation walks Torre Tavira visit Trip to Sevilla (Hotel and some meals included) Flamenco and salsa lessons Flamenco outing in Sevilla Cooking class Surfing lessons Farewell luncheon
Tentative Itinerary Friday May 31 st, 2019 - DEPART U.S. Students have the make their own arrangements to fly into Madrid and be there on Saturday June 1 st, 2019. As mentioned above, we will start our program in Madrid. Meeting point and hotel information in Madrid will be available at the Information Session during the last week of March. We will have other information sessions during the semester. Our program is from June 1 st till June 28. Classes in Cádiz will run from June 3-27, 2019. We will go back to Madrid on Friday June 28. Plan to depart Madrid to any other destination on Saturday June 29. Classes are Monday-Thursday 9:30-2:00pm. COURSE OFFERINGS: Students must fill out the study abroad equivalency form provided by the Office of Learning Abroad (http://www.uh.edu/learningabroad/start-here/courseequivalencyform.pdf). I will provide assistance to students in this process Courses available for this program: SPAN 2301 & SPAN 2302: Intermediate Spanish I /II SPAN 2307 & SPAN 2308: Intermediate Spanish for Heritage Learners I/ II SPAN 3301: Oral Communication in Spanish & SPAN 3302: Written Communication in Spanish. SPAN 3307: Public Speaking in Spanish & SPAN 3308: Written Comm. in Spanish for HS Please list the 2 courses you are planning to take 1. 2.
Payment Terms Program Conditions General Ø Once you submit your application form no later than Feb. 28, 2019, you agree to pay the full amount. The payment will appear in your UH bill. You have until March 22 to withdraw your application without any penalty (see cancellation policy below). The total program price is due preferably at the end of the program. Ø We need a copy of your passport and two pictures. Regarding Accommodation Ø The student will be charged for the replacement of items broken due either to negligence or intention on the part of the student. Ø The student may be charged for the replacement of locks if the host family s keys are either lost or stolen due to negligence on the part of the student. Regarding Expulsion Ø In the case of a serious disciplinary offense, or infringement of one of the Program Rules (see next page), MundoLengua reserves the right to expel the student from the program (both school and accommodation components) without any refund of unused portions and/or components of the program. The student will also be responsible for any fees associated with the return to his/her home country. Ø Students are also responsible for the cost of damages caused to third parties as a result of student infringement of the Program Rules (see Program Rules, next page). Regarding Cancellations Ø If the student cancels from the program after March 22 and before April 19, 2019, we will refund him/her all monies paid less applicable transaction costs ($150.00). Ø If the student cancels from the program from April 20-May 30, we will refund him/her all monies paid less $300 dollars. Ø No refunds will be paid once the program has started.
Program Rules 1. Students will respect and uphold family rules. Activities such as inviting guests to the host family s home, smoking inside the home, use of the family s telephone, and, if applicable, use of the family s Internet, must be approved by the family. 2. Students will not drive cars, motorcycles or scooters at any time during the program. In order for a student to drive any off-road motorized vehicle, the student should make a request to the director. 3. Hitchhiking or soliciting a ride from a stranger is prohibited. 4. Students must take responsibility for all personal property; MundoLengua cannot be held responsible for any student s personal property that is lost or stolen. 5. Students will not discuss their host family s private affairs with anyone other than a MundoLengua representative. 6. Students cannot change their host family without permission from a MundoLengua representative and the UH director. 7. Students must obey all local and national laws. 8. Use of illegal drugs, or association with anyone involved with illegal drugs, will result in the student being returned to his/her home country, without recourse and at the student s expense. Mandatory Medical Insurance All students participating in a Learning Abroad program are required to have international medical and emergency insurance. UH has partnered with Cultural Insurance Services International (CISI) to offer the most cost effective and robust international insurance package available to our students. 4-weeks coverage @ $ 39.65 Self enroll online by clicking this direct link: https://www.mycisi.com/cisiportalweb/pub/selfenrollment.aspx?sponsor=uh
I certify that I have read, understood and agree to the terms put forth in these Program Conditions, as well as the Program Rules which I must follow as a participant in a MundoLengua/UH program. Signature, Release/Agreement I agree that if I,, become ill or have an accident, MundoLengua or its representatives (including group coordinators, or accompanying professors) may take such action as they consider necessary to secure medical treatment, including the administration of an anaesthetic and surgery, always respecting the student religious and medical observations and traditions. Liability Release I hereby release MundoLengua/UH, its officers, Board of Directors, representatives and agents from any and all claims, charges, costs and/or causes of action whether covered by insurance or not - for loss of property, personal injury, illness, accident or death sustained by the participant during the MundoLengua program. Further Points I understand that MundoLengua s future publicity materials may include statements made by participants or their photographs. Date Misrepresentation Clause If I have personally misrepresented, or have knowledge of misrepresentation of any portion of this application, I understand and agree that MundoLengua has the option of immediately dismissing the participant from the program, and sending the participant home. In the event that I am sent home in such a case, I understand that I bear all the costs incurred and that the program fees are non-refundable. You must also register and fill out all the forms required by the University of Houston s Office of Learning Abroad. E. W. Cullen Building, Suite 105 http://www.uh.edu/learningabroad/start-here/