For Registration

Please attach the following documents to your application:

1. Registration/Application Form

2. Release, Waiver of Liability and Hold Harmless Agreement Form duly executed

3. Two recent photographs

4. Registration fee of $500 (by money order or certified cheque), payable to:

International Institute of Field Studies.

Send your application to the following address:

Program Coordinator

International Institute of Field Studies

277 Eaton Drive, Hinton, Alberta T7V 1Y5 CANADA

on or before June 30, 2009.

NEPAL PROGRAM

Everest Region Field Study Program

A Program of the International Institute of Field Studies

in collaboration with

International Centre for Integrated Mountain Development (ICIMOD).

Sep 20 – Oct 9, 2009 (Registration by June 30, 2009).

Expenses Covered:

1. International traveling (airfare) on group basis

2. All transportation within Nepal by private chartered buses

3. Lodging in hotels, lodges, resorts or in tents during trekking and rafting

4. All meals, food and non-alcoholic beverages

5. Permits, entry fees to museums, monasteries, temples etc.

6. All guides, porters, cooks, advisors, consultants, interpreters, etc. and their living expenses while accompanying group, honoraria for guest speakers, etc.

7. All gratuities, management and administration fees.

Expenses Not Covered:

1. Anything not listed above

2. Visa fees and airport departure taxes in Nepal

3. Travel taken outside Program except when authorized by Program Coordinator

4. Medical, incidental and insurance expenses for personal care and safety

5. Postage, telephone/fax, e-mail expenses for personal use, and personal gifts

6. Additional fare if extending trip beyond the duration of the Program.

Payment Schedule:

1. $500.00 to be paid with registration by June 30, 2009.

2. Balance (total minus $500 registration fee) to be paid by July 30, 2009.

3. If participant has to cut short the trip after commencement of the Program for any reason, all additional costs will have to be borne by participant.

Please Note:

1. Program may be cancelled if the number of applicants falls below minimum.

2. If for any reason the program is cancelled, there will be a full refund.

3. Other terms and conditions, as detailed in the Program Handbook, may apply.

4. Payments must be made by Money Order or Certified Cheque, payable to:

International Institute of Field Studies

Mailed on or before the due date to:

International Institute of Field Studies

277 Eaton Drive, Hinton, Alberta T7V 1Y5

Everest Region Field Study Program - 2009

A Program of the International Institute of Field Studies

277 Eaton Drive, Hinton, Alberta T7V 1Y5 CANADA

Registration/Application Form

  SECTION A:  Personal Information

  1.  Name:

2.  Address:

3.  Permanent address (if different from above):

4.  Telephone number with area code:

5.  Convenient hours to reach you:

6.  Fax number:

7.  E-mail address:

8. Date of birth:

9. Citizenship or status in Canada:

10. Profession:

(If "Student," please give name of university/college and program currently enrolled in.)

11. List major intellectual and other interests and activities:    

12. Travel experience:  

13. Please give an introduction about yourself in about 25 to 30 words that can be circulated to all Participants:   

Contact Person in Case of Emergency

14.  Name: 

15.  Mailing address: 

16. Telephone number with area code:

17. Relation to you: 

Please list any additional relevant information.

I, the undersigned, hereby apply to participate in the Everest Region Field Study Program 2009, and agree to accept the terms and conditions set out in the Release, Waiver and Hold Harmless Agreement accompanying this application, and all other applicable terms and conditions relating to my participation.

  __________________                                                _____________________________

       (City and Date)                                                                (Signature of Applicant)