Geological Field Training Course Application Form

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Personal Information

First Name

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Last/Family Name

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Current Age

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Phone Number

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Email Address

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Mailing Address

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Current Academic Information

Current Institution (College or University)

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Department

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Expected Graduation Date (month/year)

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Is Field Camp required for your degree?

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Yes, it is required

No, it is not required

List upper-level geology courses (with grade or anticipated grade) that will be completed by May 2019. Indicate courses in progress with an asterisk (*).

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Field Camp Credit Information

(Required)

I wish to enroll in 6 undergraduate credits.

I wish to enroll in 2 graduate credits.

Describe below all health-related conditions that you are aware of that may be of concern during the month-long field course. Keep in mind that some field sites are more than a one-hour drive from the nearest hospital and that you will be outside, all day at high altitude with precipitation and extremes of hot and cold. Include allergies. Do not leave blank. Indicate “none” if this is the case.

By submitting this application, you are acknowledging that you have the physical ability to hike over rough terrain while carrying a full day pack.

Health Issues Information

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Security Check

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Geology Field Camp

Geological Field Training Course Application Form

Personal Information

Current Academic Information

Department of Geology