Santa Barbara City College
Study Abroad Program
Remove this sheet before
submitting your application.
Keep for reference.
Application Procedure
Costa Rica Study Abroad Program
June 27 – July 18, 2016
Deadline for Application: May 1, 2016. Apply early as the number of places in the program is limited and as the program may fill
before the deadline. If the program is full before the deadline, acceptance is not guaranteed. Applications may be accepted after the
deadline, if space is available. This application is for participation in the Costa Rica Study Abroad Program only. To apply to the
program, please submit the following:

1. Application form. If you change addresses after submitting your application, please provide the Study Abroad Office with
your new address.
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
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2. $500 deposit check payable to Tour Resource Consultants. Please put this in an envelope and attach to your application.
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3. Responses to questions (typed or printed clearly). Please answer the questions listed on the back of the application form.
4. Two 2 x 2 photos. Two recent photos that are a full-face view are acceptable. Please trim them to fit. Pictures from a
passport service or a photo booth are acceptable. Print your name with a ballpoint pen on the back of each picture and staple
the pictures in the box on the application form. Please do not submit copy machine copies of your passport photo.
5. Completed Student Conduct Release Form. The top of this form is to be completed by you and taken/submitted to the
Office of Student Support Services in the Student Services building, Second Floor, Room SS-260. The bottom of the
form will be completed by Dean Ben Partee and returned to the SBCC Study Abroad Office. Your acceptance to the program
is not final until the form is returned to the Study Abroad Office. If you are not a current student at SBCC you need to submit
the form to the Dean of your institution for approval.

6. SBCC Enrollment. If you will not be enrolled at SBCC for the Spring 2016 semester, you must complete the SBCC
Admissions Application online at www.sbcc.edu/apply/ and enroll for the spring 2016 semester.

7. Submit your application. Applications must be complete and include the application form, answers to the questions and
photos. Incomplete applications will not hold a space in the program.
By mail:
Santa Barbara City College
Study Abroad Office
721 Cliff Drive
Santa Barbara, CA 93109
or give it to:
Santa Barbara City College
Study Abroad Office
International Education Center, Office # 1
(On SBCC East Campus at the end of the parking lot above the stadium)
Interview. After receipt of your application, you will be contacted to arrange an interview with Professor Dinklage or Phillips. For
applicants not living in the Santa Barbara area, interviews can be completed by telephone.
Notification of Acceptance by SBCC. Carola Smith, SBCC Senior Director of International Programs, will notify you of your
acceptance by SBCC to the program after your interview and after a review of your application documents.
Passports. Specific information about obtaining a passport is available online at: http://travel.state.gov, by calling (877) 487-2778, or
in Santa Barbara from the County Clerk-Recorder at 568-2250. Apply for one immediately since it may take up to twelve weeks to
obtain a passport. If you already have one, check its expiration date to make sure it will not expire until at least six months after your
return.
Program Payments. SBCC has contracted with Tour Resource Consultants
(TRC) to provide travel and logistical arrangements for the Costa Rica
program. A $500 deposit check is required at the time of application. You can
make the final program payment online at www.tourresource.com via credit
card, debit card or e-check. Please do not send the final payment to the SBCC
Study Abroad Office. All logistical and payment questions should be directed
to TRC. Questions about academics should be directed to Professors Dinklage
and Phillips. A twenty-student minimum is required or the program is subject
to cancellation.
Tentative Payment Schedule
Non-refundable
deposit payable to
Due with
Tour Resource
application
Consultants
Final payment
May 1
Total*
$500
$4,475
$4,975
Insurance. TravelGuard Travel Insurance covers travel delay, missed connection, baggage and personal effects loss, baggage delay,
medical expenses and emergency medical transportation. Additional optional cancellation insurance is available at an additional cost.
Air Transportation. TRC will organize a group flight to Costa Rica which is included in the program cost.
Cancellations. If you withdraw from the program prior to departure, you must notify the Study Abroad Office and TRC in writing.
To withdraw, please e-mail Tara Stoker at SBCC (testoker@pipeline.sbcc.edu) and Jim Froggatt at TRC (jim@tourresource.com). If
you have made your own air travel arrangements, your cancellation for your airfare is to be handled directly with the airline making
your flight arrangements and is subject to their conditions.
Housing. Students will be housed in three- and four-star hotels (double or triple occupancy) for the duration of the program. You will
be housed in hotels (double occupancy) for the duration of the program
Suggested Amount for Personal Expenses. Though personal spending habits vary widely, we suggest taking $750 - $1,000 for
personal expenses and emergency cash.
Registration. We will send you registration instructions so that you can register for the program courses online. Please do not try to
register for the courses until you have received the registration instructions since the courses are not published in the Summer
Schedule of Classes.
SBCC Fees. SBCC fees are not included in the program cost. California residents pay $46 per unit; non-California residents and
international students pay $312 per unit. You are required to enroll in 6 units. Fees are subject to change.
Mandatory Pre-Departure Meeting. Prior to departure, you will be required to attend an orientation meeting, which is tentatively
scheduled in May. At the meeting you will receive important travel information including tips about traveling in Costa Rica, health
and safety information, what to pack, money, mail, medical information, etc.
For Changes and Current Information. For updated program information, please visit the Study Abroad website at:
www.sbcc.edu/studyabroad/website/
Addresses and Phone Numbers.
Santa Barbara City College
721 Cliff Drive
Santa Barbara, CA 93109
Phone: 805 965-0581
FAX: 805 963-7222
Study Abroad Office
Tara Stoker
International Education
Center, Office #1
805 730-4294
testoker@pipeline.sbcc.edu
Program Co-Directors
Professor Bill Dinklage
EBS-111
(805) 730-4114
wsdrinklage@sbcc.edu
Professor Elizabeth Phillips
(805) 350-8888
epphillips@pipeline.sbcc.edu
All statements made on this sheet and distributed generally to prospective or accepted participants shall
be for informational purposes only and should not be interpreted as being contractual for any purpose.
 I currently attend ________________ and am attaching an SBCC enrollment form to this application.
 I currently attend ________________ and enrolled at SBCC on-line on __________________ (date).
 I currently attend SBCC.
Santa Barbara City College
Application Form

1. Staple 2- 2x2 size photos here.
2. Print your name with a ballpoint pen
on the backs of the photos.
Costa Rica
Summer Session
June 27 – July 18, 2016
Legal Name ________________________________________________________ K No. ___ ___
Last
First
Middle
___ ___
___ ___
___ ___
(Your K number is under the bar code on your SBCC student ID card .)
(as it appears in your passport)
Current Address_____________________________________________________________________________________________
Street
Apt. or Box No.
Phone (home or cell) (___ ___ ___) - ___ ___ ___ - ___ ___ ___ ___
City
State
Zip
Work phone (___ ___ ___) - ___ ___ ___ - ___ ___ ___ ___
Address after current _________________________________________________________________________________________
semester ends
Street
Apt. or Box No.
City
State
Zip
Phone after current semester ends (___ ___ ___) - ___ ___ ___ - ___ ___ ___ ___ Date of Birth ___ ___ - ___ ___ - ___ ___
Participants must be 18 years old on the day of departure.
SBCC Pipeline E-mail address ______________________________ @ __________________________(THIS WILL BE OUR
PRIMARY FORM OF COMMUNICATION WITH YOU) Please print
your e-mail address very clearly.
Secondary E-Mail ______________________________________@_______________________________
Citizenship (country) ________________
Please indicate the best times to reach you at your current phone ___________________________________________________
If you are not currently attending Santa Barbara City College, what school are you attending? ______________________________
Please list the names of two people who may be contacted in the event of an emergency. These people may be parents, guardians,
relatives, or friends.
Name _____________________________________________
____________________________________________
Address ___________________________________________
____________________________________________
City, State, Zip _____________________________________
____________________________________________
Phone ____________________________________________
____________________________________________
Relationship _______________________________________
____________________________________________
I hereby authorize SBCC representatives to contact and discuss with the persons listed above my status in the study abroad program.
I further authorize Carola Smith, Senior Director of International Programs, to review my student conduct file.
Signature _____________________________________________
Date __________________________________________
Required Legal Document Forms
If I do not complete and return the required Study Abroad legal document forms by the stated due date, I may be cancelled from the
program and held responsible for any cancellation penalties, which may apply.
Signature____________________________________________
Date _________________________________________
Medical
If you have a disability for which you will be seeking special accommodations abroad, please contact the SBCC Disabled Students
Programs and Services (DSPS) specialist immediately to begin discussions about reasonable accommodations. Phone: (805) 9680581, ext. 2364. Office: Student Services Building. The process to reach agreement on reasonable accommodations must take place
before you leave the US. Students who disclose needs at the last minute or who require accommodations that cannot be made
available in the host country, may be advised to postpone participation or consider another program
Do you have a medical condition that may prevent you from being able to function in the following or situations or to participate in
the following activities?
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Walking on uneven surfaces for at least two miles
Sitting in buses/trains/airplanes for extended periods of time
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Climbing several flights of stairs
Being able to adjust to substantially different diets
Being able to function at times in extremely hot or adverse weather conditions
If you checked any of the activities listed above, please note your medical condition. The information will be shared with our Health
and Wellness Program. If you have questions regarding your health as it relates to your ability to participate in the study abroad
program, please consult with your physician. ____________________________________________________________________
_______________________________________________________________________________________________________
Responses to Questions. On a separate sheet of paper, please answer the following questions. You may either type or clearly print
your responses. Please limit all your answers to 1 - 2 pages.
1.
2.
3.
4.
What are 5 things that you are looking forward to about studying abroad?
What are 5 challenges that currently worry you the most about going overseas?
How do you think the values and perspectives of the host country will be different from your own cultural values?
How do you think you will be perceived by the people in the host country based on your nationality and cultural heritage?
Santa Barbara City College
Dean of Students Conduct Release Form for Summer 2016 Cost Rica Study Abroad Program
To the SBCC Study Abroad Applicant:
1.
Please complete the top part of this form.
2.
If you currently attend SBCC, the form is to be submitted to the Office of Student Support Services in the Student Services
building, second floor, room SS-260. The bottom of the form will be completed by Dr. Ben Partee. Once the form is
completed by Dr. Partee, he will return it to the SBCC Study Abroad Office.
If you currently attend another college or university, give this form and an envelope that has a stamp and is addressed to
Santa Barbara City College, Study Abroad, 721 Cliff Drive, Santa Barbara, CA 93109, to the Dean of Students at your
school.
3.
Ask the dean to complete the bottom part of the form and return it to the SBCC Study Abroad Office.
Name ___________________________________________
Last
First
K No. ___ ___
Middle
___ ___
___ ___
___ ___
(if you are an SBCC student)
Address _________________________________________
City State Zip ________________________________________
Dates of Attendance at ________: From ______ to ______
Study Abroad Program location: Costa Rica
(Name of school you currently attend.)
(For example, 2012 to present)
I hereby consent to the Dean of the college I am currently attending to furnish Santa Barbara City College with the information on the
form below and I hereby waive my right of access to any statements by said Dean evaluating me and my activities.
Signature _____________________________________________
Date __________________________________________
To the Dean:
The student named above has applied to participate in a study abroad program at Santa Barbara City College. We will be grateful for
your comments that will be kept confidential.
1.
Has this student been subject to any disciplinary actions? Yes ____ No ____ If yes, please explain.
____________________________________________________________________________________________________
2.
Are any disciplinary charges pending? Yes ____ No ____ If yes, please explain.
____________________________________________________________________________________________________
3.
Has this student been expelled, suspended, placed on probation, required to withdraw, or given a reprimand or warning?
Yes ____ No ____ If yes, please explain.
____________________________________________________________________________________________________
4.
Is this student eligible to re-enroll at your college? Yes ____ No ____ Conditionally ___ If no or conditionally, please explain.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
5.
Any additional comments you may wish to make regarding this student.
________________________________________
____________________________________________________________________________________________________
Thank you for taking time to complete
this form and returning it as soon as
possible to:
Study Abroad
Santa Barbara City College
721 Cliff Drive
Santa Barbara, CA 93109
Signature ___________________________________________
Name (Please print) ___________________________________
Title _______________________________________________
Institution ___________________________________________
Phone ______________________________________________