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Tropical Ecosystem: Andes to Amazon

Application Form

Application Deadline:  FIRST FRIDAY in MARCH

 

Application Instructions

1) Download and read the Course Information Packet

The packet contains important details about the course, including prerequisites, schedule, topics for lectures and activities, what to bring, etc, etc. You should be familiar with this information before you apply!

2) Submit Application Forms:

USA & CANADIAN STUDENTS:  Please visit the University of Wisconsin's study abroad application page for all instructions and materials.

INTERNATIONAL STUDENTS:  You may submit an online form, or download the application to complete and submit via postal mail. Please be aware you must include a $100 application fee (applied to your tuition if accepted).

Ceiba Foundation for Tropical Conservation
Education Programs
1202 Williamson Street, Suite 1
Madison, WI 53703
Fax:  (608) 227-0141

Acceptance and Enrollment

Acceptances will be sent to you within approximately two weeks of the deadline at which your application was received.  All enrollment materials and instructions will be provided in your acceptance packet.

Scholarships

Ceiba has received continuing financial support from several private donors to fund our scholarship program for Ecuadorian students.  If you are an Ecuadorian student seeking a scholarship, you must follow a different application procedure.  Please see the scholarships page for details.

Late Applications

Late applications may be accepted in special cases and only if you contact Ceiba to ask for prior approval of an extension. The application fee is non-refundable for late applications.

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Tropical Ecology Field Course Application Form

(*international students only)

Personal Information

First Name:   Last Name:

Email Address:

Passport Number:

Date of Birth:  month   day   year

Place of Birth:

Sex: Male       Female

Are you a US citizen? Yes       No

If No, indicate citizenship:

Height:      Weight:

Marital status: Single       Married

Home Address

Address Line 1:

Address Line 2:

City:

State:       Zip or Postal Code:

Country:

Phone:       Fax:

Parent or Guardian Address (if different from above)

Address Line 1:

Address Line 2:

City:

State:       Zip or Postal Code:

Country:

Phone:       Fax:

Email:

Emergency Contact

Contact name:

Relationship:

Address:

City: State:     

 Zip: Country:

Daytime phone: Nighttime phone:

Email:

Academic/Employment References

Name of First Reference:

Relationship:

Company/Institution:

City:

State: Country:

Daytime phone:

Email:

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Name of Second Reference:

Relationship:

Company/Institution:

City:

State: Country:

Daytime phone:

Email:

Medical Information

Describe any physical disabilities you have:
None

List any prescription drugs you take:
None

Describe any allergies you have:
None

Can you swim?   Yes      No

Are you currently CPR certified?   Yes       No

Are you a vegetarian? Yes       No

Physician

Name:

Phone:

Medical Insurance Provider

Company:

Policy Number:

Phone:

Academic History

For each academic institution, please give the following information:
(1) Institution name, city and state
(2) Number of years completed
(3) Final GPA
(4) Graduation date or expected date of graduation

High school:

College:

Other Institution(s):

List any Biology or Ecology classes you have had:

How much Spanish do you speak, and how or where did you learn?

Essay Questions

Explain why you want to take this course:  what do you wish to gain
from your experience, and what do you hope to learn? (250 words max.)

Describe any other experience that is relevant to your participation
in the course. (250 words max.)

How might your participation contribute to the success of the course?
(250 words max.)

Submit Application
I certify that all information in this application is true and correct, and understand that my application will not be considered until all required materials have been received by Ceiba (Is my application complete?).  I further certify that I have read the course information packet in its entirety, and understand its contents.

Yes       No

Date submitted (MM/DD/YYYY):   / /

Click “Submit Application” to send your application by email.  Click “Reset” to clear your form. Click the "Back" button in your browser to return from the confirmation message you will see.

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Student Recommendation Form

The recommendation form must be completed by one of your present or prior professors or employers, evaluating your academic and personal qualifications for the field course.  The signed recommendation form must be mailed or faxed to Ceiba (see address below) and received by the application deadline.  You can obtain the recommendation form in two ways:

1)  Download and print the complete course packet, which includes the recommendation form.

2)  Download the recommendation form only (PDF), and send it to your reference:

Amazon to Andes Recommendation Form Get Adobe Acrobat Reader

 

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Download Information Packet & Application Forms

Course Info Packet Get Adobe Acrobat Reader	Application Form Only Get Adobe Acrobat Reader

Thanks for your interest in Ceiba's Tropical Ecology Field Courses!