Clark Study Abroad Programs s1

Study Abroad/Study Away Programs Phone: 508-793-7363 Clark University Fax: 508-421-3752 950 Main Street Email: [email protected] Worcester, MA 01610-1477 Website: www.clarku.edu/studyabroad

Agreement of Participation

Clark Study Abroad Programs

Program

Clark University ID Number

Conditions of Participation:

1) I understand that my participation in this program is conditional upon 1) my meeting the general requirements stated in Clark’s Guidelines for Studying Abroad /Away on Clark-Affiliated Programs, which include not being on probation or suspended from Clark University for the proposed period of study, for academic reasons, or for violations of the academic honor code or social code, and 2) confirmed admission by the host program.

2) I understand that I am required to have international health and accident insurance coverage for the entire period that I will be a participant in the study abroad program to which I have been accepted. I understand that I will automatically be enrolled in Clark’s international health and accident insurance plan offered through HTH Worldwide. I understand that if my program provider is CET, CIEE, Augsburg College, or CAPA, and similar coverage is provided by the program, then I am not required to purchase HTH, but can do so if I wish to have additional insurance coverage.

3) I understand that I am required to attend/participate in the general pre-departure meeting on Wednesday, March 27, 2013 from 2 - 4 pm in Jefferson 218; as well as all additional program orientations required by the Clark University Study Abroad and Away Programs Office or the host program.

4) I understand that it is my responsibility to inform the Study Abroad and Away Programs Office, in writing, at least 32 days prior to the start of the program, should I decide for any reason not to participate. I understand that I will be charged with all unrecoverable expenses Clark is being held responsible for at the time of my withdrawal.

5) I understand that it is my responsibility to read, and save for future reference, all application, enrollment, acceptance, immigration and arrival information provided by both the Study Abroad and Away Programs Office and the host program, and to respond to deadlines as indicated. By not adhering to deadlines and Conditions of Participation, I realize I may jeopardize my participation in the program.

6) I understand that all future communication related to my program participation will be sent to my Clark University email account.

My signature below indicates that I plan to participate in the above-mentioned Clark-sponsored study abroad/away program should I be admitted, and that I understand the conditions of my participation in the program.

Signature Date

2/13 Z://Approval Letters and Forms-1