Cuba Study Visit Application
Recognizing the value that a visit to Cuba will offer in illuminating aspects of the U.S. Government, Spanish, and Art
curriculums, we are excited to offer an opportunity for up to 24 Titans to participate in a week-long study visit to
Cuba in November. The dates of this trip will be November 5th to November 12th. See attached materials for more
information.
Important dates:
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INTEREST MEETING (STUDENTS): MAY 4TH
AT 8:15 AM in ROOM 401.
INTEREST MEETING (PARENTS): MAY 12TH
AT 7:00 PM IN ROOM 401.
APPLICATIONS DUE MAY 20TH
APPLICANTS NOTIFIED MAY 25TH
DEPOSIT ($300) DUE AND PARTICIPANT
MEETING: JUNE 1ST
REMAINDER OF PAYMENT DUE
SEPTEMBER 14TH
FALL 2016 – A schedule of meetings will be
announced upon the start of the 20162017 school year.
Eligibility:
Students must be enrolled in Academic or A.P. U.S.
History, Academic or A.P. Government (all juniors
and seniors) in the 2016-2017 school year to apply.
Additionally, sophomores that are taking Spanish
IV, Spanish V, or a visual arts course may apply.
Each student will connect their social science
(history or government) research paper to some
aspect of Cuban history, politics, or culture.
Interested students must: 1. complete the written application; 2. have two teachers complete
recommendations
Name______________________________ Grade_________
Address:____________________________ Home Phone #:_____________________
___________________________________ Parent Cell Phone #:_________________
Student Cell Phone #:________________
Parent E-mail address____________________________
Student E-mail address___________________________
Parent signature _________________________________
I have read the information about the Cuba Study Visit in which my child would like to participate and support their
desire to take part in this opportunity.
Coach signature __________________________________
Please have your coach sign if you are participating in a fall sport to indicate that you have discussed this opportunity
and the impact that your participation will have on the team with him/her.
Written application instructions
Answer the following questions on a separate sheet of paper. Utilize no more than two sheets of paper in
total to answer the following:
1. List the extra-curricular activities in which you participate, leadership positions you hold, and
community service projects in which you have taken part.
Activities and leadership experiences that demonstrate an ability to learn outside of the classroom,
adaptability, and an appreciation for other cultures are highly desirable.
2. Why do you feel you would make a good “ambassador” from Dominion High School and the United
States during this visit to Cuba?
Ideal candidates will be able to articulate the character traits that they possess, as well as prior life
experiences that have prepared them to represent Dominion and the U.S. on this trip. Prior international
travel experiences are not necessary, but candidates should demonstrate that they understand the
perceptions that Cubans may have of them, as well how they plan to leave a positive impression of
Dominion High School and America with Cuban people they will encounter on this trip.
3. What do you hope to gain from taking part in this trip?
Ideal candidates will be able to articulate how this trip will contribute to his/her “leading a life of
significance.”
Application Rubric:
Applications will be judged by the following criteria:
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Teacher recommendations (25%)
Response to question #1 (25%)
Response to question #2 (25%)
Response to question #3 (25%)
In cases of equally qualified candidates based on the above rubric, the following criteria may be
considered:
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Previous participation in international travel sponsored by DHS (preference will be given to
candidates that have not previously participated)
Candidates that are enrolled in multiple courses with curricular connections (i.e. Spanish,
Government, AND Art) will be given preference
Return completed applications to Mrs. Rodgers in room 401, Ms. Nunez-Cuevas in room 407, or Mrs. Freeman in the art room
2016 Cuba Study Visit Teacher Recommendation Form
Students are required to submit 2 teacher recommendation forms to be considered for participation in this
program. Please respond to the following questions, based on your relationship with the applicant, as
accurately and honestly as possible. Please keep in mind the physical and emotional rigors that these
international travel opportunities present, as well as the desire to have the students participating serve as
excellent representatives of Dominion High School and the United States.
Thank you!
Mrs. Rodgers, Ms. Nunez-Cuevas, and Mrs. Freeman
Return the evaluation forms to the Mrs. Jennifer Rodgers’ mailbox in the main office.
Student Name: __________________________________
Teacher Completing Recommendation: _______________________________
Relationship to Student: ____________________________________
Characteristic
Exceptional (Top Above
3% of class)
Average
Average
Below Average/
Does not exhibit
Leadership
Independence
Responsibility/Maturity
Character
Academic Achievement
Openness to new
experiences
Additional Comments:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Cuba Study Visit: November 2016
Recognizing the value that a visit to Cuba will offer in illuminating aspects of the U.S. Government, Spanish, and Art
curriculums, we are excited to offer an opportunity for up to 24 Titans to participate in a week-long study visit to Cuba in
November. The rapidly changing political and cultural landscape of Cuba offer a unique opportunity to gain insights into
Cuban Society. The U.S. government has recently relaxed restrictions on travel to Cuba and now allows for secondary
schools to participate in educational study visits to Cuba.
Dates:
November 5th to November 12th, 2016. Students will miss 3 days of school (as the trip aligns with the November teacher
workdays).
Estimated Costs:
The 7-night tour package from “Authentic Cuba Travel” cost $2099/person. We currently estimate airfare to Cuba will
cost approximately $700 - $800, bringing the total estimated trip cost to $2899/person. Students should also bring at
least $200 in spending money to cover the cost of one meal per day and other incidental expenses.
Accomodations and Itinerary:
Please see the attached information from Authentic Cuba Travel. A more detailed itinerary will be made available at the
interest meetings.
Curricular Connections:
Participating Dominion students are required to utilize the trip as an opportunity to conduct research for a project for
their social science class.
Additional information:
For more information on Authentic Cuba Travel visit:
http://www.authenticubatours.com/cuba-education-tours/all-school-tours.htm
For more information on Cuba visit the U.S. Department of State’s country briefing:
https://travel.state.gov/content/passports/en/country/cuba.html
Important dates:
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STUDENT INTEREST MEETING: MAY 4TH AT 8:15 AM in Room 401
INTEREST MEETING FOR PARENTS WANTING MORE INFORMATION: MAY 12TH AT 7:00 PM IN Room 401.
APPLICATIONS DUE MAY 20TH
APPLICANTS NOTIFIED MAY 25TH
DEPOSIT ($300) DUE AND PARTICIPANT MEETING: JUNE 1ST
REMAINDER OF PAYMENT DUE SEPTEMBER 14TH
FALL 2016 – A schedule of meetings will be announced at the start of the 2016-2017 school year.