to Fall Orientation Form 2015

advertisement
STILLMAN
New Student Orientation
2015
The Stillman College community is excited about your plans to join us in August 2015. This information will help
you in your transition into the Stillman community. Please share all information with your parents/spouse and
complete and return documents. Questions can be directed to jcurrie@stillman.edu. Stillman is a tobacco free
campus; students and guests must refrain from using any tobacoo products while on campus or attending any
Stillman College events.
Orientation and residence hall check-in will begin in the Wynn Humanities Center on Thursday, August 13,
8:30 A.M. You will receive additional instructions about the check-in process and a schedule of events via e-mail.
Information will also be posted on the Stillman website. Please go to the Stillman homepage to choose a block
schedule of classes-if you have not already done so; begin at the College Just Ahead sign on the right side of the
page. New students must report to the Wynn Center prior to going to a residence hall. Before you enter a
residence hall, please plan to spend about one hour to complete the check in process (if all documents are in
order). Please bring a navy blue short-sleeved t-shirt to campus. You will decorate the shirt as part of Orientation
activities.
Students will not be assigned a residence hall room or issued a key until the check-in process is completed.
Students are strongly encouraged to complete and submit FAFSA and other financial aid documents well in advance in
order to avoid problems during check-in. New Stillmanites should to check-in as early as possible during these hours so
that parents can attend the Campus and Behavioral Expectations session at 2:30 P.M. on August 13.
New students and their families who begin the check-in process after 3:00 P.M. on Thursday, August 13, should
plan to complete check-in and move into a residence hall on Friday, August 14. Check–in will begin at 8:30 A.M.
on Friday, August 14. Students will begin the August 14 process in the Wynn Humanities Center. Hotel information
can be accessed by googling Tuscaloosa, Alabama hotels. Please e-mail jcurrie@stillman.edu and
jbunton@stillman.edu as soon as possible should your travel plans require that you check in at Stillman after
4:00 P.M. on August 13 or 14 or on Saturday, August 15, or Sunday, August 16, so that you can receive
information about what you will need to do.
The 2015 Orientation fee is $50.00; an Orientation Confirmation Form is enclosed; you will receive a tentative
schedule of activities later. Priority date for payment is August 10, 2015. Directions for payment and form submission
are on the Orientation Confirmation Form. Information can also be submitted when you check in on August 13 or August
14. Payment will be accepted by money order, credit/debit/card, or certified check. Payment can be done at check-in.
Payment can also be done online and form can be mailed to New Student Orientation, Student Development Center,
Stillman College, 3601 Stillman Blvd., Tuscaloosa, AL 35401. Send document and/or payment using a $.49 (first class
stamp). Do not use Express, Priority, UPS, or FEDEX to return this document.
Where will I live? First year female students will live in Roulhac Residence Hall; first year male students will live in Hay
Residence Hall.
How will I get information about my meal plan? An explanation of campus dining plans is a part of this document.
Please choose a meal plan and return
What do I need to know about submitting medical information? Stillman College does not medical insurance for
its students; therefore, students must be insured through parents/guardians or go to healthinsurance.gov to
review their health insurance Students should also check with their insurance company to ensure that the
insurance has providers in the Tuscaloosa, Alabama area. Parents are strongly encouraged to review their current
health insurance plans and to provide information to the carrier than will allow your student to remain insured during their
matriculation at Stillman. The Stillman College Medical Record form is enclosed. A health care provider must
perform the student’s physical examination and must sign the medical form. College Health Services is located on the
second floor of the
Johnson-Robinson Building. A student living with a chronic illness (e.g., hypertension, diabetes, sickle cell, migraines,
asthma, allergies, seizure disorders, cancer, etc.) is strongly encouraged to obtain a referral to a physician in the
Tuscaloosa area. Contact with the Tuscaloosa physician should be made prior to the student’s entry to Stillman. If
possible, a student should bring a one to two month supply of maintenance medication to Stillman
What do I need to bring to Stillman? Linens for bed, school supplies, cleaning supplies, a stapler, toilet paper, paper
towels and two eight gb flash drives are among the items you will need. Things to Bring List and A Things Not to Bring
List are included.
What kind of clothes do I need for orientation week and for Stillman? There will be rituals designed to connect you
with the Stillman community. The attire for the rituals is black and white business/interview attire. Students should wear
comfortable shoes at the ceremonies. Men must wear ties, belts, black dress shoes, black slacks, and white long sleeved
shirts to each ceremony. Women must wear black dresses, black suits, skirts, or slacks, white blouses, and dress black
shoes. Tennis shoes, jeans, and flip-flops are not appropriate for the ceremonies. Jeans, walking shorts, t-shirts, polo
shirt, skirts, and khakis are appropriate orientation and Stillman campus attire. Fall Convocation and Confirmation
Ceremony is Thursday, September 3, 2015, 10:45 A.M., Birthright Alumni Hall. This ceremony marks the official
induction of new students into Stillman’s community of scholars and is open to the public.
What is considered inappropriate Stillman campus attire? Extremely short//tight/revealing shorts, skirts, pants, or tops;
sagging pants/shorts; do-rags, “wife beater” shirts, tattered and revealing clothing, clothing with sexually explicit
terms/symbols, profanity, or drug/alcohol related symbols are also not appropriate and should not be worn during
orientation, on the Stillman campus, or at any function where a student is representing Stillman.
What is Business/Professional Attire Day? Each Thursday is Business/ Professional Attire Day. Students and other
members of the Stillman community are expected to dress in business attire from 8:00 A.M. until 5:00 P.M. Business attire
includes a jacket, slacks, dress shirt, tie, and dress shoes for men. Women’s business attire includes a skirt suit, pants suit,
dress, jacket, skirt, blouse, and dress shoes.
How do I protect my valuables? Stillman strives to be a safe community. Students are strongly encouraged to keep
receipts for large purchases (TVs, laptops, tablets, cell phones, etc.). Items’ serial numbers should also be recorded.
Documentation of item ownership and cost is important should items be stolen or damaged.
How do I request accommodations for a disability? Stillman complies with the Americans with Disabilities Act.
Stillman students with a documented disabilities who are seeking accommodations are requested to submit copies of their
medical and/or other disability related information to Stillman College Student Development Center, ADA Information, 3601
Stillman Blvd., Tuscaloosa, AL 35401; information can be scanned and e-mailed to jcurrie@stillman.edu. Information must
state the manner in which the disability impacts the student in an academic environment and in everyday activities. Testing
should have been completed within three years of the student’s entry into Stillman College. An IEP is not acceptable
documentation of a disability; however, IEP information can be helpful in providing information about services received
during grades K-12. A meeting to discuss accommodations must be scheduled by e-mailing jcurrie@stillman.edu. No
request for accommodation will be considered until all documentation is received and a meeting has been scheduled. It is
the responsibility of the student to ensure that the SDC director has received documentation and that a meeting time has
been scheduled.
We know that you will be a wonderful addition to Stillman, and we are excited about your decision to join us.
Enjoy the rest of your summer. We look forward to seeing you on Thursday, August 13, at 8:30 A.M. in the Stinson
Building.
Sincerely,
Jacqueline W. Currie
Director, Student Development Cente
STILLMAN
NEW STUDENT ORIENTATION CONFIRMATION FORM-Fall 2015
(Please type or print using black ink.)
The cost of New Student Orientation is $50.00; payment can be made online using a credit/debit card; money
orders or certified checks will also be accepted. Form can be scanned and e-mailed to jcurrie@stillman.edu,
faxed to 205-247-8106, or mailed to New Student Orientation, Student Development Center, Stillman College, 3601
Stillman Blvd., Tuscaloosa, AL 35401. Information from form can also be emailed to jcurrie@stillman.edu with
Subject Line-Fall 2015 Orientation-Student’s Full Name. If using U.S. mail, please return Orientation Form using a
first class stamp. DO NOT USE EXPRESS, PRIORITY MAIL, UPS, or FEDEX to return orientation form to Stillman
College. Questions about orientation should be directed to jcurrie@stillman.edu; phone messages can also be
left at 205-366-8894.
_______________________ _________________________ _____________
Last Name
First Name
__M ___F ________
Middle Name
DOB
__________________________________________ ______________________________
E-mail Address
Cell Phone #
_________________________________________
_____________________ ______ ___________
Address
City
State
Zip Code
_________________________________________________________________________________________________
All on-campus students are required to have a Stillman meal plan. Please seen the enclosed meal plan sheet and
information on the Stillman website (www.stillman.edu) under campus dining for additional information.
MEAL PLAN CHOICE __19 meal plan ___15 meal plan
___10 meal plan
_________________________________________________________________________________________________
_
Are you a transfer student? ___Yes
___No
Do you have a Facebook page? ___Yes
___No
_____________________
__________________________________________________
Proposed College Major
Career Goal
List allergies/medical conditions and/or medications you use______________________________________
Did you volunteer during high school? __Yes __No
Do you want tutoring? __Yes __No
Are you interested in volunteering at Stillman? __Yes __No
In what subject(s)? ___English __Math __Reading __Science
Do you plan to work during first year of college? __Yes ___No
Were you in choir or band in high school? __Yes ___No
Will you bring a car to campus? __Yes ___No
Do you sight-read? __Yes ___No
What instrument(s) do you play? ____________________________
List skills/certifications that you have (e.g., CDL license, CPR/first aid certified, certified lifeguard, experience in a
manufacturing environment, experienced van driver, ability to design web page, knowledge, musician, experienced painter,
graphic arts experience, etc. __________________________________________________________________________
_________________________________________________________________________________________________
_
____Paid online
____Payment enclosed
____Plan to pay on-site at check-in
CAMPUS DINING MEAL PLANS INFORMATION SHEET
_______________________________________________________________________________________
Review the meal plans listed below. Choose a meal plan; place you selection on the Fall 2015 Orientation
Confirmation Form. Information about returning the document is listed to Stillman is listed on the Confirmation
Form.
________________________________________________________________________________________
19 meals per week-Three (3) meals per day Monday-Friday; two meals per day-Saturday and
Sunday
15 meals per week-Sunday-Saturday—usually equals two meals per day-Monday–
Friday; two meals per day on Saturday and Sunday; one extra meal
10-meal plan per week-Sunday-Saturday—usually equals two meals per day-MondayFriday; no meals on Saturday and Sunday
Two meals, brunch and dinner, are served on Saturday and Sunday.
Meal plans are designed to allow a specific number of meals per week. Meals cannot be carried over or
borrowed from one week to the next.
Meal plans are designed to allow a specific number of meals each week. Meals cannot be carried over or
borrowed from one week to the next. Your meal plan can be changed up to one week after registration.
Students must see the director of the residence hall they are assigned to, then meal changes are submitted to
Food Services.
Meal Cards
Selection of a Campus Dining Services Meal Plan entitles you to a Meal Card, which allows you purchasing
power equivalent to the plan you have selected. Here is how it works:
• You must have a valid meal card to enter the Hay Center Dining Hall.
• Meal cards are not transferable. You cannot loan your meal card to a friend.
Lost Meal Cards
If an ID Card is lost, a duplicate card costs $20 and may be purchased at the Cashier’s Window in the Business
Office and secured from the Office of Auxiliary Services in the Hay Center.
For additional information, please go to www.stillman.edu and click the Campus Dining link.
STILLMAN COLLEGE MEDICAL INFORMATION FORM
(Please type or print (using black ink); complete both pages of document.)
)Stillman College does not provide medical insurance for any of its students; therefore, student/parent/guardian/spouse is
responsible for all medical costs. A student seeking information about enrolling in a medical insurance plan should visit
www.healthcare.gov. Please complete the information sections. A copy of the student’s immunization record must be
attached to this form. Keep a copy of all medical information submitted to Stillman. Each student must keep a copy of
his/her insurance card on his/her possession at all times. Contact your insurance company to ensure that your insurance
has providers in the Tuscaloosa area.
______________________________ _____________________ ___________________
_______________ ____Male
___Female
Last Name
First Name
Middle Name
Date of Birth
_____________________________________ ________________ ______
__________
_________________________________
Home Address
City
State
Zip Code Country (e.g., USA, France, Nigeria, etc.)
Cell Phone # _______ ________________
Are you an international student? ____Yes ____No
Are you a student athlete? ____Yes ____No List sport(s) __________________________________________________________________
Are you seeking accommodations under the Students with Disabilities Act? ____Yes ___No
When will you attend Stillman? ___Fall ___Spring __Summer
20______
Have you had
Diseases
Vomiting food or blood
Yes
No Gallbladder disease
Measles
Yes
No Liver trouble
Mumps
Yes
No Painful bowel movement
Chickenpox
Yes
No Black or bloody stool
Diabetes
Yes
No Frequent diarrhea
Stroke
Yes
No Cramping pain in abdomen
Cancer
Yes
No Heartburn or indigestion
Tuberculosis
Yes
No Neuro-Psychiatric
Hepatitis
Yes
No Problem with nerves
Rheumatic fever or heart disease
Respiratory
Have you ever seen or been advised to see a psychiatrist?
Yes
No Do you have or have you had fainting spells?
Any trouble with lungs/TB
Yes
No Hematological
Difficulty breathing
Yes
No Are you slow to heal after cuts?
Pleurisy or pneumonia
Yes
No Have you had abnormal bruising or bleeding?
Asthma, wheezing, bronchitis
Head, Eyes, Nose, Throat
Excessive bleeding after tooth extraction or surgery?
Yes
No Sickle cell trait or disease
Eye disease or injury
Yes
No Anemia
Do you wear glasses/contacts?
Yes
No Phlebitis/blood clots
Double or blurred vision
Yes
No Locomotor-Musculoskeletal
Headaches: migraine/tension
Yes
No Pain in calves or buttocks when walking
Sneezing or runny nose
Yes
No Any difficulty in walking
Seizures
Yes
No Prosthetic limb
Ear disease/ear infections
Yes
No Broken bones (Please list)
Impaired hearing
Dizziness or transient episodes of unconsciousness
Nose bleeds
Problem swallowing
Cardiovascular
Chest pain or angina pectoris
Shortness of breath when walking or lying down
Heart trouble, heart attack, or mitral valve prolapse
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
No
No
No
Skin
Hives, eczema, rash, frequent infection, boils
Skin disease
Jaundice
Allergies (including food, medication, etc.) Please list
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Yes
Yes
Yes
Yes
No
No
No
No
Yes
Yes
No
No
Yes
No
Yes
No
High blood pressure
Yes
No
Swelling of hands, feet, or ankles
Neck stiffness
Gastrointestinal
Acid Reflux
Hernia (location)
Ulcer
Diabetes
Yes
Yes
No
No
No
No
No
No
No
Yes
Yes
Yes
Yes
Other medical conditions/surgeries (Please list)
Yes
No
STILLMAN COLLEGE MEDICAL INFORMATION FORM
____________________ _______________________ ________________ ________________________________ _______________________
Last Name
First Name
Middle Name
E-mail Address
Date of Birth
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
To be completed by medical professional
_______ _______ MMR______________ Dates_______________ TB Skin Test _____(Chest X-ray if skin test is positive)_ __________
Weight
Height
Polio____________ Date of last booster shot___________ Meningitis Vaccine_____________ Tetanus & Diphtheria (TD) ______________
Hemoglobin/Hemocrit __________ __________
Do you believe that the applicant’s health and physical examination findings
indicate that he/she is able to undertake full college work including physical education and/or collegiate/intramural athletics?
Yes___ No___
Remarks ______________________________________________________________________________________________________________
List prescription, homeopathic, and over the counter drugs used by student___________________________________________________
______________________________________________________________________________________________________________________
Physician/Practitioner Name___________________________________PhysicIan/Practitioner Signature______________________________
Address__________________________________ City_____________ State____ Zip Code_________ Phone #________________________
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------___________________________________________________________________________________________________________________________________
PERMISSION TO TREAT– MUST BE COMPLETED BY STUDENT and PARENT/GUARDIAN/SPOUSE
In the event of a medical or psychological emergency, I give consent to the attending health care provider to administer necessary
medical treatment and service to ___________________________________. I understand that Stilllman College does not provide medical
Name of Student
insurance for students and that the student/parent/guardian/spouse is responsible for all medical costs. Permission will remain in force
for the length of my tenure at Stillman College.
______________________________________
Name of Student
_____________________________
Signature of Student
_________________________________________________
__________________________________________________
Name of Parent/Guardian/Spouse (Please print)
Signature of Parent/Guardian/Spouse
____________________________________________
Name of Witness
_____________________________________________
Signature of Witness
_______________________________________
Cell Number of Parent, Guardian, Spouse
__________________________
Work Number
_________________________
Date
___________________
Date
_______________________
Date
________________________________________
___________________________
Emergency Contact Person-Adult who will be
Cell Number
contacted if parent/guardian/ spouse is unavailable
__________________________________________________________________________________________________________________________________
Completed Stillman College Medical Information Form should be mailed to Stillman College Health Service, 3602 Stillman Blvd.,
Tuscaloosa, AL 35401. Information can also be scanned and e-mailed to jcurrie@stillman.edu or brought to campus. E-mail
jcurrie@stillman.edu or call 205-366-8894. if you have additional questions. Do not enclose any non-medical information in this mailing.
Keep a copy of all medical information (including immunization records) submitted to Stillman. Please obtain refills for maintenance
prescriptions prior to the student’s entry into Stillman.
Students with chronic medical conditions (diabetes, cancer, asthma, allergies, sickle cell disease, etc.) are strongly encouraged to ensure
continuity of care by making contact with a local physician prior to enrolling at Stillman. Your local medical care provider can provide a
referral to a Tuscaloosa physician.
Revised June 2015
THINGS TO BRING
Bath Linens
Bed Linens (Long twin linens will be used in Hay, Wynn, Williams, and King Halls.)
Binders (3 ring)
Business/Interview Attire (suits, dress slacks, skirts, jackets, ties, belts, dress shoes, etc,)
Cable Splitter
Casual Attire for Class (khakis, polos, t-shirts, capris, jeans, etc.)
Cleaning Supplies (disinfectant, sponges, scouring powder, etc.)
College Ruled Paper and Composition Books
Comb and Brush
Computer and Chargers
Contact Strips (designed for hanging photos and posters without damage to walls)
Copier Paper (8.5 x 11 size)
Documentation of Illness or Disability * (for students seeking accommodations)
Driver's License/State ID Card
Electrical Surge Protectors/Extension Cords
Flash Drives (4GB, 8 GB, 16 GB)
Immunization Record (Do not submit original to Stillman)
Insurance Card/ Parents' Insurance Card(s) if you are insured through parents.)/Medicare/Medicaid Card
Mattress Covers- (2) (1 plastic and 1 cloth cover)
Microwave
Over the Counter Medications (Tylenol, cough syrup, cold/flu medication, Advil, vitamins, Benadryl)
Paper Towels
Pencils, Pencil Sharpener, Pens
Phone (for residence hall room)-Local calls only
Prescription Medication (Please obtain refills prior to coming to Stillman; prescriptions must be in original
containers.)
Refrigerator
Shower Rod and Curtains (Roulhac and Wynn Halls)
Shower Shoes
Snacks
Socks/Hosiery
Stapler and Staples
Television
Thermometer
Toilet Paper
Toiletries (deodorant, hair/personal care products, lotion, soap, toothbrushes, toothpaste, etc.)
Umbrella and Rain Gear
Voter Registration Card
THINGS NOT TO BRING
Blenders/juicers
Candles/Incense
Coffee/tea pots
Electric can openers
Grills
Hot plates
Pets
Prescription medication that is not labeled or is not prescribed for you
Sewing machines
Skillets
Toasters/toaster ovens
Weapons
Download