Religion, Rights, and Relationships in Israel and the West Bank

application form

HR-4650-730(6)/GTHEO-7362-730(6)

Religion, Rights, and Relationships in Israel and the West Bank

On-campus Classes: Jan 8, 15, 22, 29, Feb 5, 12, March 12, 19, 26 – 6:00-9:00 pm

Field Classes in Israel and West Bank: Feb 15-28, 2015

Name: ______Tel. ______

Address:

Email:

Nationality (of passport you will use for travel) ______

University of Winnipeg student ID# ______

Enrollment status Full-time: ____ Part-time: _____ Undergraduate: _____ Graduate: ______

Major: ______Credit hours completed (including current term) ____

Applying for (check one): HRGS-4650-730(6) _____ OR GTHEO-7362-730(6) ______

Check if you wish to apply for a Field Course Bursary _____

Check here if not a student, and you will be registering as Continuing Education ____

To request space in the Field Course

1.  Submit a statement (approximately 2 pages) describing your interest in the Field Course and any relevant background studies or experience. If you are requesting a bursary, add an explanatory note about your need for the bursary.

2.  Students attach a copy of your academic transcript from WebAdvisor.

3.  Enclose a down payment of $75 on the field course fee payable to “University of Winnipeg – Israel-West Bank Course.” The down payment will be returned if your application is not accepted. Date of application will be a consideration in determining acceptance into the course.

Procedures for Acceptance

Applicants will be notified of acceptance within two weeks of application being received. At the time of acceptance, the amount of the field course fee (described below) will be confirmed.

Conditions of participation

·  I understand that if I am accepted for the course, I will pay a field course fee, estimated to be $2,300. The course fee includes all lectures and educational programs, accommodation, transportation within Israel and West Bank, & admission fees for museums or sites that are part of the Field Course. Breakfasts and dinners are included in the fee; most lunches are not included. If I am accepted into the course, payment in full is due November 15, 2014.

·  Student Status -

o  Regular students - I understand that I will register and pay tuition fees as applicable for HR-4650-730(6) or GTHEO-7362(6), and participate in all pre-departure class sessions;

o  Continuing Education Students – I will pay a Continuing Education fee of $900. Continuing Education Students participants will attend all on-campus classes and complete required readings for the course, but do not need to submit assignments;

·  I understand that I am responsible for paying for my own transportation to Tel Aviv, arriving by Sunday evening, February 15, 2015, with return flight departing from Tel Aviv no earlier that noon on Saturday, February 28. (Participants have the option of either traveling as part of a group booking, or making their own travel arrangements. Our group booking airfare is $1213.45);

·  I understand that I am responsible for having a valid passport, appropriate medical insurance, and any relevant medical preparations;

·  I affirm that I have satisfactory health to engage in international travel, climb hills or stairs, and walk over uneven surfaces; and

·  I understand that I will be required to sign a Release of Liability agreement.

Signature ______Date ______

Submit to: Inquiries:

Israel-West Bank Field Course 2014

The University of Winnipeg Global College

520 Portage Avenue 204-988-7105

Winnipeg, MB R3B 2E9