Undergraduate & Graduate Nursing in Haiti
Winter 2015
Center for Global Learning & Engagement
All details are subject to change.
Haiti
APU Summer Course Session & Dates:
Course Dates: October 2015 – January 2016
Travel Dates: December 26, 2015 – January 10, 2016
Cost: $2500 + Tuition
($356 per unit – See Program Costs for Complete Information)
School of Nursing
Pam Cone, PhD
Leslie Van Dover, PhD
Course Offerings: Program Minimum Unit Requirement: 3 units, Maximum: 4 units
NOTE: Pre-requisites are Health Assessment and first nursing courses and Sophomore standing.
UNRS 282/282P (1/2 units): Global Health – Haiti
This course provides an opportunity for nursing students to explore and understand theoretically based
global health care practices and those that are specific to Haiti. This course provides an opportunity for
nursing students to participate in service and learning in another culture as part of a health care team. It is
intended to promote the delivery of health care and health education to underserved populations.
With Pre or Co-Requisite
UNRS 281 (1 unit): Introduction to Global Health (15 online hours)
The content serves to stimulate discussion and identify personal perspectives and individual cultural values
as well as approaches to and frameworks of knowledge related to the health care in the international arena.
OR
GNRS 595 (1/2 units): – Special Topics in Nursing: Global Health - Haiti, 15 hrs didactic/90 clinical hrs
Program Information
Disclaimer: Dengue fever and malaria are common in Haiti, but the winter season has a much lower rate of
malaria mosquitoes and almost no dengue fever ones in Dec/Jan season. Trip will include mountain hiking to
rural villages.
Tentative Deadlines, Meetings, & Program Itinerary Summary (Itinerary and airline schedules are subject to change.)
September 15
October 1
TBD
December 26
December 28-January 8
January 9
January 10
January
February
Application Due Date
Acceptance Meeting
Pre-Trip Class Sessions (Required)
Depart LAX
UCNH, Healthcare outreach in Rural North Haiti
Cap Haitian Hotel for Debriefing
Return to LAX
Post-trip papers/assignments due
SON Focus Group Debriefing
Program Costs & Processing
Amount
Tuition (Refer to page 1 for maximum & minimum units allowed)
UG Per Unit Amount: $356 x 3 units
$ 1068
GRAD Per Unit Amount: $627 x 3 units
$ 1881
Due Date
May 1st for Summer
If accepted you will be sent the necessary forms for course
registration.
Payment Processing
Charged to your APU Student
Account. Pay through CASHNet.
• Charged Mid-April for summer
Program Fees
Includes: airfare, international medical insurance, room, most meals, most local transportation, visa fee, &
tours/excursions
Not Included: immunizations, souvenirs, snacks, some meals, personal travel, flight deviation requests, trip
cancellation/traveler’s insurance, etc.
Undergraduate Students:
DEPOSIT $300
At time of
Cash or check to “APU” paid at
Application
All Remaining Program Costs $2100
APU University Fees
If accepted, international medical insurance is included in
your APU program costs. The CGLE/Study Abroad office will
register you for this medical insurance and send you and
email notification to your APU email in-box with the
information needed to log-in online to access your medical
insurance policy. Limited travel insurance is provided.
$ 100
With remaining Spring
payments
With remaining Spring
payments
Center for Student Action
Operations Office (South End of
Bldg. 31, East Campus) (626)8123027
Charged to your APU Student
Account upon acceptance. Pay
through CASHNet with remaining
fall payments.
Charged to your APU Student
Account upon acceptance. Pay
through CASHNet with remaining
spring OR fall payments.
Notes
• Deposits are non-refundable (unless denied acceptance).
• All costs are estimated, based on current exchange rates, a minimum enrollment # and subject to change at any time.
• Additional APU Fees: $125 for independent study courses & Other (Check the APU website for any additional fees for applicable courses.)
• Passports: If you need to apply for a passport, you must begin the process now as your airline ticket cannot be processed without proof of a
valid passport. For all passport information, visit: http://travel.state.gov/passport/get/first/first_830.html &
http://www.apu.edu/studyabroad/resources/passport/
Total:
Applying to the Program
Submit your completed program application to the CGLE/Study Abroad Office (refer to list of forms needed on
application cover page). Applicant status notifications are sent by email to all applicants’ APU email address 2-3
weeks after the application due date listed in the application packet.
To Turn in ALL Applications, Forms & Payments Contact
For All Program Questions Contact
Center for Global Learning & Engagement
Faculty Information:
APU Study Abroad
701 E. Foothill Blvd. • PO Box 7000
Azusa, CA 91702
OFFICE (626)857-2440 • FAX (626)857-2444
studyabroad@apu.edu • www.apu.edu/studyabroad
Pamela Cone
pcone@apu.edu
Leslie Van Dover
lvandover@apu.edu
Center for Global Learning and Engagement
Department of Art & Design in Europe Application
Date of Application: ________________________________ □ Summer/Year: ______ □ Winter/Year: ______
Personal Information:
Legal Name: ____________________________________________ APU ID #: ________________________
Cell Phone (_____) _____________________________
Other Phone (_____) _______________________
APU Box #: ________ APU Email Address: ___________________________________
□ Academic Requirement(s): The program listed above has a minimum Cum GPA Requirement of - 2.5
Unofficial Transcripts are required to be attached with your application & are available through home.apu.edu.
□ Intended Course Enrollment: List the details of each course you intend to take during this program.
If accepted, you will be sent information on when/how actual registration will take place.
Course ID #
Course Title
# of Units
□ Essay Responses - Questions for applicant to answer on separate pages & submit with application:
1. Why are you interested in studying in this location?
2. How do you anticipate studying abroad affecting your academic/career goals?
3. How do you anticipate studying abroad affecting your personal growth & service/ministry goals?
4. What cross-cultural or personal experiences have helped to prepare you for studying in a challenging, new
environment?
5. What personal hesitations or difficulties do you anticipate within this study abroad experience?
6. What are your top 5 Strengths? (from the StrengthsFinder) Pick one and describe how you envision it being
used if chosen to be a part of this study abroad program.
Additional Materials To Be Attached With the Above Items: (paperclip as one bundle, do not staple separately)
Undergraduate Forms
□ Undergraduate Short-Term Financial Planning Form
□ Study Away Student Agreements Form
(with required One Stop Signature)
□ $300 Program Deposit Paid At One Stop: Cashier
□ Copy of Passport Picture Page
(or copy of document showing full legal name to appear on passport)
APPLICATION POLICY: APU Discipline Clearances & Acceptance Process
Applicant status notifications are sent by email to applicants’ APU email address 2-3 weeks after the application due date. In order to create and
maintain a safe and God-honoring environment for all of our study away programs, the Center for Global Learning & Engagement (CGLE) will be
requesting a complete “discipline clearance” for each applicant from: Academic Advising (clearance from academic probation), Residence Life,
Student Life, Communiversity, and any other relevant department (at the discretion of the CGLE). Applicants are not officially accepted to the
program without this clearance. APU reserves the right to deny a student based on their discipline history at APU. If a student discipline issue occurs
after acceptance or during the program, the student may be cancelled from the program and will lose any non-refundable monies or pre-payments
made on the student’s behalf. If there are any questions regarding this process, please contact the CGLE.
Application Deadline: October 13-20, 2015
Applicant’s Signature: ____________________________________ Date:
_________________________
Date: ____________________
By signing this application form you are agreeing to the application policy above and confirming all application information provided is true to your knowledge.
Send applications to: APU Center for Global Learning & Engagement, Attn: Study Away
701 East Foothill Blvd., PO Box 7000, Azusa, CA 91702 • (626)857-2440 • FAX (626)857-2444 •
studyabroad@apu.edu
6.2013
Center for Global Learning and Engagement
(Summer/Winter)
UG Short-Term Financial Planning
Name: ________________________ APU ID#: _______________ □ Summer/Year: _____ □ Winter/Year: _____
Study Abroad Program: ________________________ Program Location or Institution: __________________
(i.e. “SBM China”)
(i.e. “China, APU”)
DIRECTIONS: This form is for all UG students registering for programs/courses during the summer or winter terms.
1.) Refer to your study abroad program to fill in beginning financial information & sign the participant signature line, 2.) Drop off the
form at One Stop for remaining needed information & the required ONE STOP signature. 3.) Once signed by One Stop, they will scan &
email the signed form to you for your records and deliver the paper form to the CGLE/Study Abroad Office for processing.
NOTE: GLT students registering for GLT courses during fall or spring should use the “Semester Study Abroad Financial Planning” form.
APU Short-Term Programs
NON-APU Short-Term Programs
Students must be registered
through APU.
AuSable, CCCU, Creation Care & OPUS students must register
through APU. Other programs may or may not offer the option to
register through their program OR through APU. How you
register will adjust charges & affect course status as being
transfer units or not. Check with One Stop, Study Abroad & your
academic department to see which option is best for you.
Registration
APU’s Tuition Rate x ___ units
Can be found at program
website, brochure, or other.
Program’s Tuition & Program Costs can be
found at program website, brochure, or
other.
Study Abroad
Administrative Fee
(N/A)
$500 ONLY IF registering through APU for courses
University Service Fee
Health Fee/Medical Ins.
Summer Programs Only = $100
Domestic = $0 OR Int’l = $100
Summer Programs Only = $100
Domestic = $0 OR Int’l = $100
Tuition
Program Costs
SUBTOTAL PROGRAM COST:
SUBTOTAL PROGRAM COST:
Estimated
Credit on Account
Estimated
Alternative Aid
TOTAL PROGRAM BALANCE:
TOTAL PROGRAM BALANCE:
APU PROGRAM PAYMENTS:
Deposit
□
Program Costs
(Everything except
Tuition)
Tuition
▪ Deposit Processing & Due Date: Your required deposit is due with your application. The amount is taken out of your
Program Costs & is the only portion not paid online, it must be processed at the One Stop: Cashier
▪ Payment Processing & Due Dates: The program costs portion of your program will be charged to your student account
upon acceptance & divided among all remaining payment due dates for the semester prior to your short-term program (fall
payment dates for winter & spring payment dates for summer).
▪ Payment Processing: The tuition portion of your program will be charged to your account mid-October for winter and
mid-April for summer.
▪ Payment Due Date: All tuition must be paid by December 1st for winter & May 1st for summer
NON-APU PROGRAM PAYMENTS:
▪ Payment Processing: The total program costs & tuition of your program will be charged to your student account upon
All Program
acceptance & divided among all remaining payment due dates for the semester prior to your short-term program (fall
Costs & Tuition
payment dates for winter & spring payment dates for summer).
POLICIES: Signing below confirms knowledge of and acceptance to the following policies & website link information…
□
 Summer/Winter FINANCIAL AID: Although financial aid cannot be given for the sole purpose of a winter or summer program, any financial aid credit
on your student account from a previous semester can be applied to a summer/winter program. Additionally, alternative loans may be an option to
assist with expenses during your term abroad. Once you have estimated your program’s financial needs, One Stop can assist with information
regarding other financing options (i.e. additional PLUS /private school loans, etc).
 If charges change from time of estimation to time of invoice, fees will be adjusted accordingly to the student’s account. Charges subject to change
without notice. Although APU One Stop provides assistance with financial needs, it is the student’s responsibility to research and be aware of total
program cost and estimated financial aid for their study abroad program.
 Additional Policies listed at: http://www.apu.edu/studyabroad/financial/
 REFUND POLICY: See Full Policy at: http://www.apu.edu/studyabroad/financial/refund/ Participants will be held responsible to pay all assessed charges of
what is paid for if deemed non-refundable by vendors. I understand that I am responsible for the program deposit/confirmation amount and assessed
charges in the event of my cancellation. If APU is the host institution and cancels the entire program, fees are reimbursable.
________
Participant’s Signature
2.2015
____________
Date
_________
APU ONE STOP Signature*
(*Required)
____________
Date
Center for Global Learning and Engagement
(Int’l & Domestic)
Study Away Student Agreements
Name: ___________________________________________________ APU ID#: ______________________
APU Off-Campus Program: ________________________________ Semester/Term: ____________________
Expected Cumulative Units Completed Prior to Your Study Away Term: ____________________________________
What will be your Academic Level at the time of your Off-Campus Program:
□ Freshman □ Sophomore □ Junior □ Senior □ Masters □ Doctoral □ APS □ Other:
___________________
Have you participated/Will be participating in additional Study Away program(s)? □ Yes □ No
If Yes, Program(s):________________________________________ Term(s):____________________________
Major/Program: ________________________________________
2nd Major/Program: ______________________________________
Minor: ________________________________________________
Expected Graduation Term (i.e. December 2055): __________________
Top 5 Strengths (from Strengths Finder, if available):
1. ______________________________
2. ______________________________
3. ______________________________
4. ______________________________
5. ______________________________
A. Student Standards of Conduct Policy
In order to create and maintain a safe and God-honoring environment for all of our study away programs, the Center for Global Learning &
Engagement (CGLE) will be requesting a complete “discipline clearance” for each undergraduate applicant from: Academic Advising
(clearance from academic probation), Residence Life, Student Life, Communiversity, and any other relevant department (at the discretion of
the CGLE). Applicants are not officially accepted to the program without this clearance. All participants of an APU administered or endorsed
off-campus study program shall be subject to the “Standards of Conduct” policy appearing in the APU Undergraduate Student Handbook, APU
Graduate Catalog, or any similar standards set by the particular program. In the case of conflicting standards, the more stringent standard
applies. APU reserves the right to deny a student based on their discipline history at APU. If a student discipline issue occurs after acceptance
or during the program, the student may be cancelled from the program and will lose any non-refundable monies or pre-payments made on the
student’s behalf. Because of the possibility of serious effects on group safety and coherence, on-field staff will deal with violations immediately
and has discretion to imposing sanctions after investigating and holding a formal or informal hearing. The opportunity for appeal is limited by
the nature of the study away experience. Additional sanctions may be imposed upon the student’s return to campus.
B. Student Disability and Healthcare Abroad
The CGLE, is committed to assisting all students in selecting study abroad opportunities that meet their needs, including students with
disabilities. Many towns, communities, and institutions abroad are not equipped with wheelchair access or easily accessible for hearing or
vision impairments or offer mental health support. Further, some trips require activities that may be strenuous for some participants, including
long climbs or hikes. The CGLE in conjunction with APU’s Learning Enrichment Center (LEC) will seek to advise students to appropriate study
abroad programs for any disability needs. Program directors and the CGLE will do as much as possible to ensure the overall safety of study
abroad participants. However, specific or special needs should be researched by the individual participant. The CGLE can assist students
with medication translation, healthcare facilities in nearby areas abroad, personal emergency planning, copies of important medical or travel
documents (copies of passports, prescriptions, health insurance policies, etc.). If a student participant receives accommodation from the LEC,
has been treated for depression, anxiety, eating disorders, or anything else that can be classified as a mental health condition, students should
contact the LEC for information in a timely manner at (626) 815-3849 for accommodation information to be deemed reasonable and/or required.
Students should also obtain any appropriate insurance coverage for treatment abroad, separate from the global medical insurance provided
from Azusa Pacific University if needed.
C. General Agreements
1.) I authorize APU to use the photo from my student account and/or photos taken during the extent of my study away program for
forms, marketing materials and recruitment. You can opt out of this by checking here: □
2.) I authorize APU to share my name and email address with other study away students. You can opt out of this by checking here: □
D. Financial Agreements
I will abide by APU’s Refund Policy as stated at: http://www.apu.edu/studyabroad/financial/refund/ or the refund policy included within my
specific program of study. The more stringent will apply.
E. Graduation Agreements & Studying Away Senior Year (Undergraduate Students)
Seniors are not allowed to study away their last semester. Any student intending to study away their final semester must request APU’s
General Petition Form from the One Stop Office and submit the completed form to One Stop. Students are responsible to adhere to the
Intent to Graduate deadlines listed in the academic calendar. Intent to Graduate forms for May and July are due in mid-November and
Intent to Graduate forms for December are due in mid-April. If you have above 90 units, and are studying away during these deadlines, you
will be sent an email to your APU account from One Stop with a link to an electronic version of the Intent to Graduate Form. It is your
responsibility to fill out the form and submit to One Stop by the deadline. Forms submitted late will be subject to a $200 late fee. Your
Academic Specialist will then initiate the graduation clearance process for you. If you have any questions about this process, please contact
One Stop at onestop@apu.edu or 888-788-6090.
By signing below you are stating that you have thoroughly read each policy and are in agreement to follow each policy.
________________
Participant’s Signature
_____
Date
08.2015