Florida COASTAL School of Law
SUMMER STUDY ABROAD PROGRAM– Clermont-Ferrand, France (“Program”) APPLICATION
Submit application in person or print and mail (1) completed application, (2) non-refundable registration fee of $300, and (3) letter of good standing (not required of FCSL students) by March 28, 2014, to:
Katharine Hartland, Program Director
8787 Baypine Road
Jacksonville, FL 32256
Office No. 516
E-mail:
Web site: http://fcsl.edu/summerinfrance
PLEASE ANSWER ALL QUESTIONS.
□ FCSL Student □Non-FCSL Student
Passport Number: ______
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1. U.S. SOCIAL SECURITY NUMBER
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2. NAME (LAST, FIRST)
3. MAILING/BILLING ADDRESS:
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
4. DATE OF BIRTH: ______
(Month, Day, Year)
PLACE OF BIRTH: ______
(Important: include City, State, and Country)
5. □ MALE □FEMALE
6. CITIZENSHIP: □U.S. CITIZEN □NON-RESIDENT ALIEN □PERMANENT RESIDENT
7. COUNTRY OF CITIZENSHIP, IF NOT A U.S. CITIZEN: ______
8. PERMANENT ADDRESS (if different from mailing address, above):
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
9. NON-FCSL STUDENTS*: LAW SCHOOL ADDRESS:
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NAME OF LAW SCHOOL
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
10. NON-FCSL STUDENTS: NAME OF LAW SCHOOL REPRESENTATIVE TO WHOM A FINAL TRANSCRIPT SHOULD BE MAILED:
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11. LAW SCHOOL YEARS COMPLETED (BY MAY 26, 2014): □1 YEAR □2 YEARS
GRAD. DATE ______
12. LAW SCHOOL GRADE POINT AVERAGE (AS OF TODAY’S DATE): ______
14. EMERGENCY CONTACT:
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NAME
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
*If you are a student and are not enrolled at FCSL, please have the dean or registrar from your law school send a letter of good standing. The letter should approve the transfer of credits from FCSL toward the J.D. degree at the law school of your matriculation. Letters of good standing are due by March 28, 2014.
15. COURSE SELECTION: YOU MAY SELECT ALL COURSES, BUT AT LEAST FOUR CREDIT HOURS MUST BE SELECTED. TUITION IS $943 PER CREDIT HOUR:
□Comparative Criminal Justice – Prof. Christopher Roederer - 2 credits
□International Human Trafficking Law and Policy – Prof. Ericka Curran – 2 credits
□European Union Law – Prof. Marie Elizabeth Baudoin – 2 credits
□French Business Law – Prof. Allison Fiorentino – 1 credit
16. FINANCIAL AID: PLEASE INDICATE WHETHER YOU WILL BE REQUESTING FINANCIAL AID ASSISTANCE TO ATTEND THE PROGRAM:
□YES □NO
REGISTRATION FEE DUE UPON SUBMISSION. APPLICATION DEADLINE IS MARCH 28, 2014. ENROLLMENT IS LIMITED. BALANCE DUE MAY 26, 2014 (BUT WITHDRAWAL DEADLINE IS APRIL 15, 2014). MAKE CHECKS PAYABLE TO FLORIDA COASTAL SCHOOL OF LAW.
Please note: Students who submit this application and then elect to not attend the program must complete a drop from and submit to the Registrar’s Office no later than April 15, 2014. Students who have not completed a drop form by this date will be financially liable for the tuition for the course(s).
□ I have enclosed my registration fee of $300 (check or money order). The tuition balance must be remitted no later than May 26, 2014.
□I have enclosed full payment of tuition and fees.
( (a) tuition for 4 credit hours: $3,772; (b) tuition for 5 credit hours: $4,715; or (c) tuition for 6 credit hours: $5,658)
□ I will be making payment via my credit card. I understand that a 2% convenience fee will be charged. Credit card payments must be made using the student web portal. Non-FCSL students should contact the FCSL Registrar to create a portal.
Student Information Sharing:
I agree that my name, address, telephone number, and e-mail address may be given to other students registered for the program.
Travel:
I understand that I am solely responsible for my own travel from the U.S. to France and to, from, and within the town of Clermont-Ferrand, including travel, lodging, and meals that may be necessary to attend field trips in other parts of Europe. Field trips organized by FCSL or by the University of Auvergne are optional, and I may elect not to attend some or all of these trips.
Code of Conduct:
I agree to abide by FCSL’s Student Code of Conduct and any additional rules of conduct specific to this Program that may be provided to me and as amended from time to time. In the event I fail to comply with the FCSL Student Code of Conduct or additional program rules of conduct, FCSL may immediately eject me from the Program, deny me credit for the courses I am taking during the Program, and otherwise take any other action permitted to FCSL under the FCSL Student Code of Conduct. FCSL is not required to make any refund of tuition due to action taken as a result of a student’s violation of the FCSL Student Code of Conduct or any additional program rules of conduct.
Release and Assumption of Risk
I agree to release FCSL from all liability, and I assume the following risk:
(1) In the event of an emergency that necessitates the administration of medical care, hospitalization, or surgery, I authorize FCSL and/or the University of Auvergne, through its authorized professors, representatives or agents or other administrators in charge of the Program, to secure any necessary treatment for me, including the administration of an anesthetic and/or surgery. I understand that such treatment is solely at my expense, and I agree to reimburse FCSL for any expenses it may incur on account of such injury or treatment.
(2) I agree to release and hold harmless FCSL and the University of Auvergne, their officers, administrators, employees, professors, and any professor, administrator, agent, tour organizer or arranger employed by FCSL or the University of Auvergne, from any and all claims and causes of action for damage to or loss of property, personal injury, illness or death arising during, in connection with, or immediately before or after the Program, including but not limited to any travel, or any activity conducted by or under the control of FCSL or the University of Auvergne with regard to this Program.
(3) I agree to indemnify and hold harmless FCSL, its officers, professors, administrators, employees and agents with regard to any claims or causes of action for damage to or loss of property, personal injury, illness, or death, which was caused in whole or in part by me.
Housing Indemnification:
I agree and acknowledge that although FCSL may assist me in finding housing for my use during the Program, I am ultimately responsible for finding my own housing. FCSL is not responsible for any housing or living arrangements during the Program, and FCSL shall have no liability whatsoever for any claim, injury, damage to property or any other liability related to my room and board while in France. I agree to indemnify and hold FCSL harmless for any damage to property, injury to person, or for any liability whatsoever related to my rental of a room or other type of housing during the Program. In the event that any apartment management, the University of Auvergne, or any other party charges FCSL for any damage to or cleaning fees for any housing rented by me, I agree to pay such charges immediately or to reimburse FCSL immediately for such charges, as necessary. Furthermore, I agree to pay any costs or expenses, including but not limited to attorney fees that FCSL may incur to enforce this application.
CERTIFICATION – REQUIRED
I certify that I have read, understood and agreed to the terms of the Program contained in this application. The information on this application is correct, and I understand that on becoming a participant in the Program I shall be subject to FCSL regulations, the FCSL Student Code of Conduct, and other Program guidelines. I understand that FCSL reserves the right to require withdrawal of any student as a result of unsatisfactory performance or behavior, academic or otherwise.
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SIGNATURE DATE
How did you hear about FCSL’s summer study abroad program?
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