Center for International Education Study Abroad Application This

Center for International Education
Study Abroad Application
This document is required for all study abroad applications. Students who complete a study
abroad application will automatically be considered for a study abroad scholarship.
Please print or type.
Trip Interest:
Summer ☐ Spring Break ☐
Name:
(Name as it appears exactly in your passport)
Address:
City:
State:
Zip:
Date of Birth:
Cell Phone Number:
Home Number (If different from cell):
Emergency contact name and number:
E-Mail:
Are you currently enrolled at NCC? Yes ☐ No ☐
NCC ID#:
Current Major:
Current GPA:
Are you a US Citizen?: Yes ☐ No☐
If no, please describe your status:
Have you ever participated in a NCC study abroad program? Yes ☐ No ☐
Have you ever traveled abroad? Yes ☐ No ☐
If so, where and when?
The following information is voluntary and will be used for the sole purpose of providing
statistical data to our funding agencies. This information will not be used for making study
abroad or scholarship decisions.
Please check all appropriate boxes:
☐ Male
☐ Female
☐ American Indian or Alaska Native
☐ Asian
☐ Native Hawaiian or Other Pacific Islander
☐ Black or African American
☐ White
☐ Hispanic/Latino
Are you a US military veteran? Yes ☐ No ☐
If yes, which branch?
Application Statement of Interest
The statement of interest is your opportunity to personalize your application. In the space below, or
on a separate sheet of paper, please write a short statement on your interest in this program. You may
want to describe what impact studying abroad will have on your personal, academic, or professional
goals. Please feel free to draw on your past personal history, your academic interests, your career
goals, or anything else that will help us understand your interest in the program.
Please return this application form and accompanying documents to Center for International
Education, College Center 287, Northampton Community College, Bethlehem, PA 18020. Our
contact information is 610-861-4157 or email [email protected]
Cancellation and Refund Policy:
Participants must inform NCC in writing if they choose to cancel their participation in the
program. All correspondence should be addressed to NCC, Center for International Education,
3835 Green Pond Road, Bethlehem, PA 18020, phone, or email. Please be aware that NCC is
required to make various deposits to reserve accommodations, air tickets, in-country travel, etc.
For this reason, no refunds will be given after the refund deadline. After this date, students will
be responsible for the full payment of all airline tickets even if he/she chooses not to travel.
Airline tickets are always non-refundable. Refunds will be processed according to the
student’s Higher One Refund Preference. NCC reserves the right to apply refunds against
outstanding past-due balances owed to the college. If student does not pay in full for program, a
hold will be placed on his/her account and will not be released until all fees have been paid.
Deposit of Funds
All tuition and fees associated with study abroad and spring break trips will be charged to the
student's Tuition Bill, and will be due with the published Tuition Due date for that session. All
payments must be made to the NCC Bursar's Office. Tuition for registration after the tuition due
date is due immediately. The Tuition Payment plan is available, however an additional down
payment may be required at the time of enrollment and payment plan must be paid-to-date prior
to travel. See the Bursar's Office for additional information or to enroll.
Total Balance
All outstanding program fees must be paid one week prior to departure.
Participation Guidelines
In order for a student to travel abroad, he/she must meet these minimum requirements:
1.) Be at 18 years of age. If under 18, student must have parent/guardian approval.
2.) Be enrolled in classes at NCC or a December graduate of the subsequent NCC
semester.
3.) Have no “holds” on his/her student accounts.
4.) Good social standing and clear disciplinary record. Must follow the NCC Code
of Conduct at all times.
5.) Be making academic process (a satisfactory GPA as determined by the
International department and Academic Affairs).
6.) Be willing to follow the rules and regulations of the program and participate in
all the activities scheduled.
7.) Students age 21 or older cannot consume alcohol in front of program staff.
8.) Students under the age of 21 cannot consume alcohol regardless of the laws of
the country.
9.) Students may not smoke in front of program staff and other participants and may
only smoke in designated areas.
___________________________
Applicant Signature
Date
___________________________
Parent/Guardian Signature (under 18 only)
Date