France 2015 Summer Study Abroad Program

France 2015 Summer Study Abroad Program Applications accepted beginning December 1, 2014. No applications accepted prior to this date.
Applicant Information 1. First Name:_____________________
Middle Name:________________
Last Name:________________________
2. Current
Address:
City:_____________________ ST: ____________ Zip: _______________
Country:_____________________
☐ Check here if current address is same as
permanent address and proceed to #4.
4. Email: _________________________________
3. Permanent
Address:
Mobile phone: __________________________
City: _____________________ ST: ____________ Zip: ____________
Other phone: ___________________________
Country: _________________________________________
Note to University of Iowa Students: Your @uiowa.edu email is the official email address used by the University to communicate with you. All official communication
will be sent to that address. To setup or configure your email account, visit My Ulowa at http://isis.uiowa.edu.
If yes, Hawk ID:________________Student ID #______________ 5. Are you a University of Iowa student? Yes☐ No☐
If no, please indicate your current law school:
Semesters completed by May 2015. ________________
6. Are you a United States Citizen? Yes☐ No☐
Date of Birth: ______________ Male☐
Female☐
Note: Admitted students will be required to submit copies of their passport, green card, or other appropriate documentation prior to departure.
Do you have a passport? Yes☐
No☐
Passport Number: __________________ Expiration Date: __________________
Full name as it appears on your passport: _________________________________ Country of Issue:_____________________
Emergency Contact Information Contact's Full Name: _______________________________________________
Relationship: ________________________
Address: _______________________________________________
City: _____________________ ST: _________ Zip: ____________
Email: ______________________________
Country: _________________________________________________
Phone: ______________________________
Course Selection (minimum of 2): ☐
Introduction to the Law of France (2 cr)
Law in the Muslim World (2 cr)
Building the State (2 cr)
Please indicate command of French language, if any: __________________________________________ __________________________________________ Housing Preference: ☐
Two person studio
☐
One person studio—additional fee will be assessed.
Please contact us at law-studyabroad@uiowa.edu for more
information.
If you wish to share an apartment with a specific individual,
please provide his/her full name. Please indicate if this individual
is a program participant or non-participant.
Name:_______________________________________________
Program Participant:
Yes☐ No☐
Do you smoke?
Yes☐ No☐
UNIVERSITY OF IOWA FRANCE 2015 SUMMER STUDY ABROAD PROGRAM IN COMPARATIVE AND INTERNATIONAL LAW GENERAL CONDITIONS (1) This program is organized and administered by The University of Iowa College of Law
in cooperation with various French institutions. The program is described at:
http://www.law.uiowa.edu/academics/arcachon .
(2) The right is reserved to cancel the program prior to departure or to alter it at any time if The
University of Iowa College of Law determines that circumstances, including lack of sufficient
enrollment, require such cancellation or alteration. In case of cancellation by the University full
refund of all fees paid will constitute full settlement with the enrollee.
(3) Neither The University of Iowa, its directors and employees, nor the Iowa Program and its
sponsoring institutions or its program staff shall be liable for any loss, damage, injury, delay,
irregularity, or additional expense arising from the acts or omissions of any providers of
services or accommodations, or due to strikes, war, civil disturbances, weather, quarantines,
sickness, government restriction or regulation, or from any other cause whatsoever. The
program enrollee, by submitting this application, agrees to be bound by this statement of
conditions, and waives any such claim against the aforementioned agencies and persons.
(4) The enrollee further agrees as follows:
(a)
That, as a participant in the program, the enrollee will be required to
purchase the health and evacuation insurance provided by the UI International
Programs Study Abroad Office. You will receive information about this policy
when you register with the UI International Programs Study Abroad Office.
Further information on this policy may be found here.
(b)
The University of Iowa and the Iowa Program, along with its
sponsoring institutions, and their directors and employees, are released from any
and all responsibility and expense resulting from any health or accident problems
incurred by the enrollee in transit to and from the program and during the program;
(c)
That the enrollee will have sufficient funds (a minimum of $1000 is
recommended) over and above the cost of the program to maintain the enrollee and
to provide for emergencies;
(d)
That all fees and deposits paid in connection with the program are
nonrefundable after April 22, 2015, except in the case of certifiable personal medical
emergency;
(e)
That the enrollee will not withdraw from the program after April 22, 2015,
except as described in the preceding clause;
(f)
That the University of Iowa, the Iowa Program and its sponsoring institutions
are not liable for the actions of any enrollee, or the results thereof;
(g)
That these general conditions apply to any and all family members who may
accompany the enrollee for any portion of the program;
(h)
That the enrollee has read and understood the conditions set forth above and on
the website.
UNIVERSITY OF IOWA FRANCE 2015 SUMMER STUDY ABROAD PROGRAM IN COMPARATIVE AND INTERNATIONAL LAW RELEASE AND ASSUMPTION OF RISK (1) In consideration of my being permitted to participate as a student in the Iowa Program in
France, operated under the auspices of The University of Iowa College of Law, as part of its
academic curriculum, I do hereby release the University from liability and assume the risk as
follows:
(2) I understand that on rare occasions an eme rgency may develop which necessitates the
administration of medical care, hospitalization, or surgery. Therefore, in the event of injury or
illness to me (my spouse, son, daughter) I hereby authorize The University of Iowa, by and
through its au thorized representative(s) or agen t(s) or the host institution coordinators or
advisors in charge of said program, to secu re any necessary treatment, including the
administration of an anesthetic and surgery. It is understood that such treatment shall be solely
at my expense and I agree to reimburse the University for any expenses which it might suffer
on account of said injury or treatment thereof.
(3) I agree to release the University, its officers and employees, any agent, tour organizer, or
arranger employed by the University, and the host and sponsoring school in Europe, from any
and all claims and causes of action for damage to or loss of property, personal injury, illness or
death, arising out of any travel or activity conducted by or under the control of the University
with regard to the aforesaid Program.
(4) I agree to indemnify and hold harmless the University, its officers, employees and agents,
with regard to any claims and causes of action for damage to or loss of property, personal
injury, illness, or death which I cause.
UNIVERSITY OF IOWA FRANCE 2015 SUMMER STUDY ABROAD PROGRAM IN COMPARATIVE AND INTERNATIONAL LAW APPLICATION SUBMISSION By submitting this application, you are agreeing to the terms and conditions outlined on
the GENERAL CONDITIONS and RELEASE AND ASSUMPTION OF RISK pages
of this document.
Your application will not be considered complete until the following are received:
☐ Completed application and course selection form.
☐ Letter of good standing from your home institution. (Not applicable to UI students.)
☐ $100 non-refundable application fee. Click here to pay online. (Save this document
before clicking to pay or changes will be lost.)
If you think that you will require special accommodations to participate in the program, please
contact us at law-studyabroad@uiowa.edu BEFORE submitting this application.
To submit your application online, save this completed form to your computer and email to
law-studyabroad@uiowa.edu. Please be aware that the application will not be processed until
the non-refundable deposit of $100 has been received. Click here to pay. (Save this
document before clicking to pay or changes will be lost.) You will receive an email
confirmation when your application is received, and when your application fee is received.
To submit a paper application, print the completed form, in its entirety, and return to the
address provided below. If you wish to pay the $100 application fee by check, please include a
check, made payable to the University of Iowa College of Law, with your application.
Please return your completed application form to:
Kelley Winebold
France Study Abroad Program
University of Iowa College of Law
405 Boyd Law Building
Iowa City, IA 52242-1113
Applications accepted beginning December 1, 2014. No applications or deposit
payments will be accepted prior to this date.