Apply Now to C.S. Lewis Oxford Study Abroad

Your First & Last Name:*

Email Address:*

Mailing Address:*

City:*

State:*

Zip:*

Cell Phone:*

Gender:*

 

Male
Female

Are you a U.S. citizen?*

 

Yes
No

Are you interested in taking this course for credit:*

Credit
Not for Credit

Are you currently taking classes at Regent University:*

Yes
No

If you are not a Regent student how did you hear about this trip:

Passport Number:*

Passport expiration date (must be valid for at least six (6) months beyond the dates of your trip.):*

Birthday (Month/Day/Year):*

 

Which Regent University school(s) are you enrolled in (please list any joint degree schools):*

School of Business & Leadership
School of Communication & the Arts
School of Divinity
School of Education
School of Government
School of Law
School of Psychology & Counseling
School of Undergraduate Studies
N/A

What is your Degree: (N/A if not a student)*

What is your Major:(N/A if not a student)*

Have you talked to your student advisor at comadvising@regent.edu to confirm that this course will be used towards your degree:*

Yes
No
N/A

Who is your faculty mentor for your current Regent Program: (N/A if not a student)*

Student I.D. #: (N/A if not a student)*

As a study abroad participant, I agree to conform to the Code of Conduct (pp. 29-33) contained in the Regent Student Handbook that applies to all Learning Abroad Programs:*
Yes
No

I understand that only Regent students confirmed to be in good standing by Student Services and the Business office will be permitted to attend this course.

PROOF OF TRAVEL, PROOF OF PASSPORT AND INTERNATIONAL LIABILITY WAIVER
Forward copy of valid passport, and your completed and signed International Liability Waiver to Margie Ackerman no later than March 10, 2017.

Regent University
Attn: Margie Ackerman
1000 Regent University Drive, COM 240
Virginia Beach, VA 23464
Fax: (757) 352-4291
Email: mackerman@regent.edu

Proof of Valid Passport & Travel Visa
I understand that a VALID PASSPORT IS REQUIRED FOR THIS TRIP and that it must be valid for at least 6 months beyond initial entry into the United Kingdom. It is also recommended that you carry a copy of your passport with you on the trip. I am forwarding a copy of my passport to Margie Ackerman

International Liability Waiver
I have reviewed, completed and signed the Regent University International Liability Waiver. The same Code of Conduct contained in the Student Handbook applies to learning abroad programs and activities. I will forward a copy of the completed form to Margie Ackerman.

Liability
Regent University does not assume liability for injury, damage, loss, accident, delay, or irregularity which may be occasioned by reason or defect, through the acts or defaults or any company or person engaged in conveying the participants of this tour or in carrying out the arrangements of the tour, or as direct or indirect results of acts of nature, breakdowns in machinery or equipment, acts of governments or other authorities, de jure or de facto, wars, whether declared or not; hostilities, civil disturbances, strikes, riots, theft, pilferage, epidemics, quarantines, medical or customs regulations, loss or damage resulting from improper passports, visas, or other documents or from any causes beyond the control of the University. The University can accept no responsibility for loss or additional expenses due to delay or changes in schedule or other causes. We have the right to refuse to accept or retain any tour participant should such person's health or general deportment impede the operation of the tour to the detriment of other participants. All rates are based on tariffs in effect at the time the tour was planned and are subject to change in the event of adjustments therein. Baggage is carried at the owner's risk and baggage insurance is recommended. The issuance of tickets and vouchers will be deemed to be consent to the above conditions.

The participant's signature below (type your name) and participation in this trip constitute acceptance of this provision and agreement by such participant that Regent University shall not be liable or responsible in any way whatsoever for any inconvenience, loss, damage, or injury arising out of or in connection with such tour services. By typing my name below, I acknowledge that I have read and fully understand the conditions and responsibility area of the enrollment application and verify the information I have provided as truthful and correct.

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