Health and Human Rights in Social Context

APPLICATION FORM

HR-4650 (6) Health and Human Rights in Social Context An Interdisciplinary Field Course in Manitoba and Botswana

Spring 2018

Classes: (On Campus) Logistics and Orientation: to be scheduled at a mutually agreeable time Manitoba Component: May 1, May 3, Field Trip May 4, May 8, May 10, Field trip May 11 Botswana Component: May 20- June 2 Debriefing: three meetings to be scheduled at a mutually agreeable time

Name: ______Tel. ______

Address: Email: Nationality (of passport you will use for travel) ______University of Winnipeg student ID# ______Enrollment status Full-time: ____ Part-time: _____ Undergraduate: _____ Graduate: ______Major: ______Credit hours completed (including current term) ____ Check if you wish to apply for a Field Course Bursary _____ Check if you intend to complete a practicum in Botswana following the field course _____ Check here if not a student, and you will be registering as Continuing Education ____

To request space in the Field Course 1. Submit a statement (approximately 2 pages single spaced) describing your interest in the Field Course and any relevant background studies or experience. If you are requesting a bursary, add an explanatory note about your need for the bursary. If you intend to complete a practicum please indicate this in your application. 2. Students should attach a copy of your academic transcript from WebAdvisor. 3. Enclose a down payment of $75 on the field course fee payable to “University of Winnipeg – Botswana Field Course.” The down payment will be returned if your application is not accepted.

Procedures for Acceptance Date of application will be a consideration in determining acceptance into the course, along with the information provided in the application. Applicants normally will be notified of acceptance within two weeks of an application being received. The deadline for applications is Monday February 26th.

Conditions of participation  I understand that if I am accepted for the course, I will register for the course, pay tuition and pay a field course fee, estimated to be $2,500.  I understand that I am responsible for paying for my return airfare to Botswana.  The course fee includes all lectures and educational programs, accommodation, transportation related to the course in Manitoba, and all transportation within Botswana, & admission fees for museums or sites that are part of the Field Course. Breakfasts and dinners are included in the fee, along with some lunches; some lunches are not included. If I am accepted into the course, payment in full is due April 5 2018.

Student Status -

o Regular students - I understand that I will register and pay tuition fees as applicable for HR- 4650, and participate in all pre-departure class sessions; o Continuing Education Students – I will pay a Continuing Education fee of $975. Continuing Education Students participants will attend all on-campus classes and complete required readings for the course, but do not need to submit assignments;  I understand that I am responsible for paying for my own transportation to Gaborone, arriving by air at Sir Seretse Khama International Airport no later than noon on May 20th, and arranging to depart on or after June 3rd. The cost of airfare is usually between $1800-$2000. There may be a group airfare option, please contact Dr. Kristi Kenyon ([email protected]) for more information after October 1st.

 I understand that I am responsible for having a valid passport, appropriate medical insurance, and any relevant medical preparations;

 I affirm that I have satisfactory health to engage in international travel, climb hills or stairs, and walk over uneven surfaces, and sit for long periods of time (bus travel); and

 I understand that I will be required comply with University of Winnipeg safety protocols for international field courses and to sign a Release of Liability agreement.

Signature ______Date ______

Submit to: Inquiries: Botswana Field Course The University of Winnipeg Global College [email protected] 520 Portage Avenue 204-988-7107 Winnipeg, MB R3B 2E9