Age (to be used when making room arrangements)
I would like to participate in the following seminar(s):
What are your specific interests, goals and expectations for the above program(s)?
Which of your experiences, classes, or interests are related to the above programs? What is your current career or career interest and institutional affiliation?
Residential preference, if possible:
building (with lounge) double occupancy
with double or triple occupancy
(with lounge) double occupancy
cabin double occupancy
Do you have any personal habits, preferences, or concerns that you would
like us to consider when assigning roommates?
Do you smoke or snore?
Meal plan choice:
plan (required for residents)
commuter meal plan (lunches and Sunday dinner required; other meals by
Do you have any special dietary requirements or food allergies we should
be aware of?
significant dietary restrictions
I am a
am a "vegetarian," but I do occasionally eat:
I have the following special dietary requirements/allergies:
Are you fully able to participate in field trips, some of which may involve hiking over uneven and/or awkward terrain? Please indicate any concerns you might have and how we might be able to help you.
Do you have any special medical conditions we should be aware of?
Are you requesting a general discount? Only one of the following may be requested.
Institute alumnus(a) of 1 previous seminar (10%)
Institute alumnus(a) of 2-3 previous seminars
Institute alumnus(a) of 4+ previous seminars
I am a graduate student currently enrolled in a Latin American
If you are a student, please list your university or college. If you are
an alumnus, please list seminars you have attended.
Are you requesting a general
scholarship? Scholarships range from 10 - 50%. The number of
scholarships is limited. Why do you think you merit and need an award?
How much are you requesting?
organization or agency information.
Each agency form should have name of participant and seminar title,
instructor, and dates.
Full payment is
not due until you arrive for the seminar. If you
are being sponsored by an organization or agency, will you be making payment for
the seminar costs (tuition, meals, accommodations, other fees) with:
check or credit card
one combined purchase order or authorized training form
several separate purchase orders or authorized training forms
Applications for university credits or CEUs will be available at the
seminar. There is an application fee.
Would you like to earn university credits?
Would you like to earn continuing education units?
Are you interested in possibly carpooling if someone inquires?
If yes from where?
Other pertinent information, comments, questions, etc., are welcome!
In case of emergency, contact:
*Emergency Contact Name
*Emergency Contact Phone
A deposit is
required to register your application and save your place in the
seminar. Ecological Restoration seminar deposits are $175 and all other
seminar deposits are $100. *
I am faxing a copy or emailing a pdf of a purchase order to cover the
I will make the required deposit payment
online (Once you submit this application, you will be
given the option of going to the secure server to make this payment.)
I understand that during my participation in this seminar, reasonable
efforts will be made to assure my comfort and safety both at the host
facility and in the field. I recognize my own responsibilities in this
regard. Full details on liability are available.
(type your name)