Educational International Packet

EDUCATIONAL INTERNATIONAL PACKET

STUDENT INFORMATION

Student Full Legal Name:

Date of Birth:   Student ID:

Phone:   Email:

Nationality:   Primary Language:

PASSPORT & VISA INFORMATION

Passport Number:   Issuing Country:

Passport Expiration Date:   Visa Type:   Visa Expiration:

PARENT / GUARDIAN INFORMATION

Relationship:   Phone:

PROGRAM ENROLLMENT & FINANCIALS

Program Name:   Program Level/Grade:

Program Start Date:   Program End Date:

Exchange program    Full-time    Short-term / Summer    Language immersion

Full payment due on enrollment    Installment plan (see schedule)    Scholarship / Financial Aid applied

Deposit Amount:   Deposit Due Date:

ACADEMIC POLICY ACKNOWLEDGMENT

By selecting the boxes below and signing this packet, the signer acknowledges and accepts the program's academic and conduct standards. Failure to comply with academic integrity, attendance, or program conduct standards may result in disciplinary action, including dismissal without refund. The institution reserves discretion to determine sanctions consistent with published policies.

I acknowledge the Academic Integrity policy
I acknowledge the Attendance and Participation requirements
I acknowledge the Student Code of Conduct and understand disciplinary consequences

MEDICAL, INSURANCE, AND EMERGENCY

Relationship:   Phone:

I authorize the program and its agents to obtain emergency medical treatment for the student if needed and understand I will be notified as soon as reasonably possible. I agree to assume financial responsibility for such treatment.

TRAVEL & HOUSING

I authorize the student to travel on approved local and international activities organized by the program. I understand participation may involve travel by public transport, private vehicle, or walking and that the student must comply with program rules while in transit.

Arrival Date:   Departure Date:

PHOTO & MEDIA RELEASE

I grant permission for the program to record, photograph, and use my or my child's likeness, voice, and statements in connection with program promotion and reporting. I understand that such media may be used in print or digital formats and waive any right to inspect or approve uses.

I consent to photo and media use    I do not consent to photo and media use

DATA PRIVACY & RECORDS RELEASE

By signing, the signer authorizes disclosure of academic records and necessary personal information to the program partners, host institutions, and sponsor organizations for the purpose of enrollment, credit transfer, visa processing, and health and safety administration. Records disclosed under this authorization will be limited to that which is necessary to accomplish the stated purposes.

I authorize release of educational records as described    I limit release of directory information

LIABILITY, ASSUMPTION OF RISK, AND INSURANCE

I acknowledge that participation in international programs involves inherent risks, including but not limited to transportation incidents, illness, political unrest, and other hazards. On behalf of myself or the student named herein, I assume all risks and release the institution, its employees, agents, and partner organizations from liability for personal injury, property damage, or death except where caused by gross negligence or willful misconduct. This release shall be interpreted in accordance with applicable law and does not waive rights that cannot be lawfully waived.

I understand that adequate health and travel insurance is required and that I am responsible for ensuring coverage for the duration of the program. Proof of insurance may be requested.

I have read and accept the Liability and Assumption of Risk clause

ADDITIONAL INFORMATION

SIGNATURE & CERTIFICATION

Certification: I certify that the information provided in this packet is true and complete to the best of my knowledge. I agree to comply with program policies and recognize that falsification or omission of required information may result in denial of participation or dismissal. I have read and understand the terms of tuition, refund, and disciplinary policies as set forth in this packet.

Sign Now