Application for Course Credit Enrolment Form – IFS First Name* Last Name* Student Number* Home Address - Street* City/Province* Postal Code* Phone: (Home) Phone: (Local) Phone: (Cell)* Destination Country of International Field Study* Travel Dates: Departure*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Travel Dates: Return*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Current Program of Study* Full Time / Part Time Enrolment*Full TimePart TimeCurrent Term of Enrolment* If you do not know what your current term of enrolment is, please contact your Academic Advisor for confirmation.Academic Level* If you do not know what your current academic level is, please contact your Academic Advisor for confirmation.Level of International Field Study course you are applying for*General Education 3 credit elective (Diploma Level) SOCL 1127Liberal Arts 3 credit elective (Degree Level) IDPL 9101I am aware that I am applying for credit recognition for an International Field Study Elective, and that it is my responsibility to attend the required academic orientation session prior to departing on my field study and to be fully aware of my academic and financial obligations to successfully complete this course.*-Yes, I am awareNo, I am not awareI will be attending the mandatory pre-departure meeting at the-NOTL CampusWelland CampusFor those attending the NOTL Campus for their mandatory pre-departure orientation, please select the date you will be attending-March 10th, 8:30-9:30 AM in W208 (IDPL 9105)March 10th, 8:30-9:30 AM in W305 (SOCL 1127)March 17th, 8:30-9:30 AM in W208 (IDPL 9105)March 17th, 8:30-9:30 AM in W305 (SOCL 1127)For those attending the Welland Campus for their mandatory pre-departure orientation, please select the date you will be attending-March 18th, 9:30-10:30 AM in S202 (SOCL 1127)March 19th, 9:30-10:30 AM in S234 (SOCL 1127)Signature