How to apply:

1. Please contact the Environmental Learning Institute before applying to be sure there is still space available on the program. Secure permission to participate from your school, if necessary.

2. You can copy the required forms from your browser and paste them into WORD, or print out forms from the website.

3. Complete the Application Form below.

4. Give the Reference Form to a teacher/professor or academic advisor who is well acquainted with you and your academic performance. Ask them to complete it and return it to you. Alternatively, you can ask your reference to email us directly (silverberg@alum.mit.edu).

5. We encourage you to email these forms back to us. It saves paper, energy and postage. You can copy the forms from your browser and paste them into WORD. If necessary, please mail completed forms to: Admissions, Environmental Learning Institute, PO Box 3727, Tucson, AZ 85722 USA

Once accepted:

1. You need to pay your non-refundable program fee deposit. This $300 non-refundable deposit is due within 10 days of being accepted in the program. You can do this by PAYPAL or by check. Please write your $300 fee deposit check to Environmental Learning Institute, mail it to Admissions, Environmental Learning Institute, PO Box 3727, Tucson, AZ 85722 USA.

2. You must have a passport to participate in our international programs. Since 9/11 it is necessary even for programs in Canada and Mexico. If you do not have a passport please initiate securing one immediately. For Canada and Mexico an original official birth certificate and drivers license will suffice.

3. Please give the Medical Form to your health care provider. Ask them to complete it and return it to you.

4. Complete the Informed Consent Form.

5. If applying for the financial aid scholarship (generally up to $500), complete the Financial Aid Form.

6. Mail signed, hard copies of ALL forms to Admissions, Environmental Learning Institute, PO Box 3727, Tucson, AZ 85722 USA. Include a photocopy of the information page of your passport (or original birth certificate). Include a photocopy of your health insurance card and include the insurer's phone number.

7. Please pay any outstanding amount of the program or course fee by six weeks prior to the course start date. Thank you.

Environmental Learning Institute Undergraduate Programs
2004-2005 Application for Admission Form

Personal Information

Name:

Social Security Number (if applicable):

Birthdate:

Mailing Address

Street:

City:

State:

Zip Code:

Phone:

E-Mail:

Permanent Address

Street:

City:

State:

Zip Code:

Phone:

E-Mail:

I am applying to the following program

Title:

Dates:

Are you applying for financial aid?

Passport/Birth Certificate Information

Do you have a passport?

What is the number?

What is the expiration date?

Do you have an Official Copy of your Birth Certificate?

Health Insurance Information

My health insurance company is:

My health insurance policy number is:

The phone number for my health insurance company is:

Will your health insurance cover you overseas?

Education

College/University Name:

Major (actual or intended):

Date of Graduation:

Science Courses Taken:

Additional Information

Name of Parent(s) or Guardian or Spouse or person to contact in case of an emergency:

Telephone #:

Parent's Address:

Experience and Interests

Extracurricular activities/clubs or organizations:

Off-campus study programs in which you have taken part:

Outdoor/camping experience:

Backpacking experience:

Travel experience (when, where, with whom, how long):

Career plans (if known):

I have read the Environmental Learning Institute course description, syllabus, personal equipment list, personal clothing list, informed consent form, medical form. I feel that I understand and would enjoy and benefit from the academic experience they describe. I certify that all information I have provided on this form and in the other required forms are correct and accurate to the best of my knowledge.

Applicant signature:

Date: