|
Application for the 2007/2008 Programs |
|||
Part III – DOCUMENTS (to
be mailed)
Semester programs TUITION DOWN PAYMENT:
Immersion programs TUITION DOWN PAYMENT:
The down payment should accompany this application to ensure one's place in the 2007/2008 Programs. Make Kenya shillings cheques payable to MARYKNOLL INSTITUTE OF AFRICAN STUDIES. Other currencies pay to: MICHAEL C. KIRWEN A/C MIAS. If the down payment is not possible at this time, please explain the reasons why and indicate when payment will be made: (explanation)____________________________________________________________________________ STATEMENT OF WAIVER I understand that certain risks are inherent in participation in the Maryknoll Institute of African Studies of Saint Mary's University of Minnesota/USA and Tangaza College, Nairobi, Kenya. I agree to assume those risks. I further agree to hold the Maryknoll Fathers and Brothers, Saint Mary's University of Minnesota/USA and Tangaza College, Nairobi, Kenya and their representatives harmless of any and all liability that may arise in connection with participation in the Maryknoll Institute of African Studies Programs, Nairobi, Kenya. (Your Signature): ___________________________________________ (Date): __________________________________________________ ATTACH TWO PASSPORT SIZE PHOTOS:
FIRST LETTER OF
RECOMMENDATION: 2007/2008 Programs
_______________________________________________ has applied to
participate in the program(s) of the Maryknoll Institute
of African Studies of Saint Mary's University of Minnesota/USA and Tangaza
College, Nairobi, Kenya. The programs involve adjustment to a foreign
culture, adjustment to living in a hostel, or in a church or religious
community guest house in the Nairobi area, field research and accredited
academic study of African life and reality. In light of this description would you please comment on: (1) the extent and nature of your acquaintance with the
applicant: (2) their capacity to successfully participate in the
kind of program described above. (Please use both sides of this sheet if
necessary). Please return no later than July 15, 2007 for Aug-Nov 2007 Semester Program, Dec 15, 2007 for Jan-Apr 2008 Semester Program, April 15, 2008 for 2008 Immersion Programs to:
Name of Reference: ______________________________________________________________________ Address: _______________________________________________________________________________ Position or Title: ___________________________Date:
_________________________________________ SECOND LETTER OF RECOMMENDATION: 2007/2008 Programs
In light of this description would you please comment on: (1) the extent and nature of your acquaintance with the
applicant: (2) their capacity to successfully participate in the
kind of program described above. (Please use both sides of this sheet if
necessary). Thank you for your valuable cooperation. Please return no later than July 15, 2007 for Aug-Nov 2007 Semester Program, Dec 15, 2007 for Jan-Apr 2008 Semester Program, April 15, 2008 for 2008 Immersion Programs to:
Name of Reference: ______________________________________________________ Address: _________________________________________________________________ Position or Title: ___________________________Date:
_______________________ DOCTOR'S REPORT: 2007/2008 IMMERSION
PROGRAM Dear Doctor, The undersigned _______________________________________ has applied for the program(s) of the Maryknoll Institute of African Studies located in Kenya, East Africa. This is an eleven week Immersion program of study and research with some traveling. For most of the time the participants live and study in Nairobi, Kenya which is situated on a plateau 5,200 feet above sea level. While extraordinary physical rigors are not demanded, living conditions demand good physical health. The weather for most of the program is mild 45 - 80 Fahrenheit degrees, combining intense tropical sunshine with rain, dampness and overcast skies. Furthermore, Kenya is in a malarial area and there is some slight risk of becoming infected on travel outside of the city of Nairobi, if one does not take proper precautions. Besides the normal wear and tear of life in a culture quite different from that of the United States or other Western countries, the program is not that demanding. However immature persons, or persons in poor physical condition or with coronary or respiratory problems, severe allergies, or ambulatory limitations would find the program taxing or even dangerous. Also, it is difficult for the program to provide special diets. Upon examination of the applicant, would you please express your judgment as to their physical and mental capability for such a program. This statement is for the information of the program and will not in any way hold the physician legally liable for the applicant's acceptance into the program or for any injury or illness that might occur during the program. Thank you for your cooperation. Please return no later than July 15, 2007 for Aug-Nov 2007 Semester Program, Dec 15, 2007 for Jan-Apr 2008 Semester Program, April 15, 2008 for 2008 Immersion Programs to:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Upon examination I find ___________________________________to be in sufficient good health for the Maryknoll Institute of African Studies described above. Upon examination I would not recommend_________________________________ as being in sufficient good health for the Maryknoll Institute of African Studies described above. Physician's Name: _____________________________________________ Address:
_____________________________________________________________ |