APPLICATION FOR ADMISSION TO THE FAU SUMMER 2005 ARCHAEOLOGY AND ETHNOGRAPHIC FIELD SCHOOL IN SALANGO, ECUADOR

Please print this application and send to: Valentina Martinez, Department of Anthropology, Florida Atlantic University, Boca Raton, FL 33431 or email it to vmartine@fau.edu. If you have any questions please call (561) 297-3230 or e-mail mharris@fau.edu

Please circle which program you are applying for: Archaeology Ethnography

Name_______________________________ SS#______________________________

E-Mail ____________________________

Present Address_______________________________________________________________________________________________________________________________________________________________________________________________

Telephone_________________________

Date of Birth_____________________ Sex: M F

Florida resident? Yes No

University/College now attending/Major___________________________________________________

GPA_________

Academic interests____________________________________________________________

Passport # (if available) _______________________________ Exp. Date___________________________

Date______________Signature______________________________________________

I. Explain why you are interested in the program.

II. Is there anything we should know about you that will impact your performance in the field program?

III. Health Profile

How do you rate your overall physical condition? Excellent Good Average Fair Poor

State any physical disabilities or anything in your medical history that we should know about (allergies, respiratory problems, contact lenses, etc.).






IV. Dietary Profile

Can you adapt to unfamiliar foods and a menu that includes "exotic" dishes?

Are there any medical, religious or personal restrictions on your diet? Are you a vegetarian? (We do our best to be flexible with food preparation for vegetarians; we request that participants show some flexibility as well.)

V. Adaptability

What experiences have you had that reflect your capacity to adapt to unusual living conditions in a culture other than your own?

VI. Do you speak Spanish? Yes No

Please rate your speaking ability: Excellent Good Average Fair Poor

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VII. Emergency Information (emergency contact person)

Name__________________________________________________

Address________________________________________________

______________________________________________________

Phone: Home_______________Work_______________________

Relationship____________________________________________