Acknowledgement & Disclosure Form - GateWay Community College

Acknowledgement & Disclosure Form - GateWay Community College

GateWay Community College Study Abroad ProgramPrague, Czech Republic: City of 100 SpiresJune 1 – June 30, 2015Disclosure and Acknowledgment FormExperience your studies in real-time. Gain an educational and personal adventure by studying abroad in Prague.Studying abroad provides you with a chance to understand a different perspective and appreciate a differentculture, all while learning your studies in more depth.Daily interactions in a foreign country with an unfamiliar language can help you build skills that you normallymight not have the opportunity to develop, such as creative problem solving, communication, flexibility,adaptability, expanded worldview, independence and self-confidence, all valuable career skills.NOTE:National scholarships for study abroad programs are available at early to increase your chances of securing funding.Before you embark on this journey please read the Disclosure and complete and return theAcknowledgment Form.

GWCC Study Abroad Program Prague 2015Disclosure1. Cost• Tuition - $84.00 per credit hour• Registration Fee - $15.00• Trip Fee - $2393.00• Airfare - $1,200.00 - $1,500.00• Meals - $500.00NOTE: Out-of-State Students in Study Abroad Programs pay $201.00 per credit hour. The TripFee includes transportation in Prague and to Vienna or to the venue your class will be studying in,lodging, instructional support, etc. Airfare and meal costs are estimates.National scholarships for study abroad programs are available at early to increase your chances of securing funding.2. Payment Information• Tuition and Registration Fee - Payment in full is due 35 days (March 21) prior to the class start date.Please be aware that if you enroll fewer than 35 days from the classstart date, tuition and the registration fee will be due the same day you enroll.• Trip Fee - Payment in full is due no later than April 30, 2015• All payments should be made to the GateWay Cashier's Office and can be in the form of:o Cash - in person (IE1214)o Check - in person or via mail (GateWay Cashier's Office, 108 North 40th Street Phoenix, AZ85034)o Credit Card - in person, by phone (602-286-8277) or through the Online Student Center atmy.maricopa.edu3. Refund Policy• Tuition and Registration Fee - Students have three calendar days including the class start date to drop thecourse and receive a 100% refund.• Trip Fee - If the student chooses to drop from the program for any reason after the payment deadline, butprior to departure, the trip fee may be refunded on the following basis:o 100% refund if cancellation occurs before April 30, 2015o 50% refund if cancellation occurs between April 30 – May 1, 2015o 0% refund if cancellation occurs after May 2, 2015NOTE: The Trip Fee refund policy is based on the College's financial commitments for faculty salary,faculty airfare, ground transportation, accommodations, and instructional space in the Czech Republicthat have to be paid in advance of departure. This program is a self-funded program; once monies havebeen spent on behalf of a participant, it is impossible to secure a refund.4. Class CancellationIf the class you have selected is cancelled, you will be offered a spot in another class.

5. Program CancellationGWCC Study Abroad Program Prague 2015DisclosureIt is a primary goal of GateWay Community College to provide a dependable, safe, enjoyable, andacademically sound study abroad experience for all participants. Every effort has been made in thedevelopment of this program to ensure the best possible study abroad experience for its participants.However, neither the Maricopa County Community College District nor GateWay Community College cancontrol all circumstances. If the program is cancelled, students will be refunded 100% of their tuition,registration fee and trip fee.6. Itinerary ChangesGateWay Community College and the Prague program are not responsible for any costs incurred by aparticipant who alters their itinerary after tickets (air, train, coach, etc.) have been purchased.7. Student Rights and ResponsibilitiesStudents must adhere to all Maricopa County Community College District and GateWay CommunityCollege policies, administrative regulations, and provisions as outlined in the Maricopa Governance OnlinePolicy Manual ( andthe 2014-2015 GateWay Community College Catalog & Student Handbook ( Students with DisabilitiesGateWay Community College makes reasonable accommodations for students with disabilities who areotherwise qualified to participate in its activities and programs. However, the Americans with DisabilitiesAct does not govern accessibility standards in other countries and the College is not responsible for assuringaccessibility in all Study Abroad locations. While the College will try to accommodate special needs,students with disabilities must know that some international experiences may not be appropriate for them.In order to address this concern, students who will need accommodations should notify the DisabilityResources and Services (602) 286-8888 office of their interest in participating in the internationalexperience. The Coordinator of Disability Resources and Services will meet with the student, ProgramDirector designee and other relevant personnel to determine whether the student's needs can beaccommodated.9. While in Prague• The residences are open and available June 9 – June 30. If you decide to travel prior to or after the datesthe residences are open, keep in mind you will have to make arrangements for your ownaccommodations.• There will be a number of field trips and guided tours which require extensive walking on steep hills andcobblestone streets. You should be in reasonably good shape to participate in all the activities of theprogram.• If you withdraw from your study abroad course while in Prague, you are no longer considered to be inthe Prague program and may not stay in the college provided lodging or partake in any college activities.

GWCC Study Abroad Program Prague 2015Acknowledgement FormPlease print and complete this document. Please deliver an original copy to Susan Mills at aninformation session or mail to the address below.I have read and agree to all the term stated above.I agree to notify the study abroad program director of any changes to theinformation provided in my application.I agree to participate in all orientation sessions & classes scheduled prior to departure.I understand that my application will be reviewed and can be accepted or denied.I certify that all information on my application is correct as of the date of submission.____________________________________________________________Print Student Name____________________________________________________________Student Signature and Date____________________________________________________________Susan Mills, Program Director (480) 242-8358Susan MillsPrague Program DirectorGateWay Community College108 North 40 th StreetPhoenix, AZ 85034Revised 12.10.2013

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