Center for the Study of Eurasian Nomads
Dorno-Altai Excavation
2158 Palomar Ave.
Ventura, CA 93001 USA
Phone: (805) 653-2607 * FAX: (805) 653-2607
e-mail: jkimball@csen.org
APPLICATION FOR
SUMMER 2004 EXPEDITION
THE DORNO-ALTAI EXCAVATION
PROJECT DATES FOR VOLUNTEERS
TAX DEDUCTIBLE CONTRIBUTION PER SESSION
APPLICATION AND CONTRIBUTION DEPOSIT DEADLINES
-
APPLICATION AND DEPOSIT
OF $300 DUE NO LATER THAN APRIL 15, 2004
-
FINAL CONTRIBUTION OF $1100
DUE NO LATER THAN JUNE 1, 2004
Note: The essential official
visa for the excavation requires approximately FIVE weeks to obtain.
A visa will not be granted until the entire
contribution is paid.
If you are not accepted, your deposit will be refunded.
If you are accepted and you withdraw more than 30 days before
the beginning of the first session, 50% of your deposit will be
refunded. If you withdraw after 30 days before the beginning of
the first session, no refund will be made. However, the deposit
remains tax-deductible. If the project is cancelled, your complete
deposit will be refunded.
If you plan on staying in Mongolia longer than your
excavastion session, you must include this information on your application
so that the extra time can be included in your Visa. Visas for U.S.
residents will be obtained from the Mongolian Embassy in Washington
DC. After the invitation is sen to the Consulate the applicant should
send his/her Visa Application to the appropriate Embassy. Further
information is available at the Mongolian
Embassy.
Length of Stay in Mongolia: Beginning Date _____________________
Ending Date ____________________
If you are applying from out of the United States,
please specify the Mongolian Consulate (or Embassy) where your
Mongolian Visa invitation should be sent. Provide the information
below:
Mongolian Consulate
Street Address___________________________________________________________________________________________
City, County, Zip__________________________________________________________________
Telephone __________________ FAX ___________________
Email _________________________
Personal Information
Name_____________________________________________Birthdate______________________
Address_________________________________________________________________________
City _____________________________________________State ______
Zip_________
Mailing Address if different from above_______________________________________________
Home phone (_____) ________Work or school phone( ___)_________
Mobile__________________
E-mail address ___________________________ and ____________________________________
Social Security number___________________S ex_____ Height_______
Weight______
Passport number_____________________________ Expires_________ Type___________
Include a xerox copy of the two front pages of your passport.
Employer or school_________________________________________________________________
Address of work or school___________________________________________________________
Phone number, work or school (___)_____________________________________
If retired, former employer __________________________________________________________
Address _________________________________________________________________________
Please include a photograph of yourself in the application.
Emergency contact: Name____________________________________Relationship________________
Home address_____________________________________________________________________
Work address_____________________________________________________________________
Home Phone(____) _______ Cell Phone(____) ___________ Work Phone(___)
_______________
e-mail_______________________________________________
We prefer to contact you by email, so if your email address changes
after you have submitted an application, please noify us.
Special Interests
Please describe your special interest in this project, and
what experience you have had that might be helpful on this project.
Attach extra pages if necessary on a separate page, Please list
all educational background that is pertinent.
Previous Travel. On a separate page, briefly tell us about any previous
foreign travel, which countries you have visited and when.
PLEASE ATTACH CV and REFERENCES (important)
Medical Conditions
Medical treatment will not be equal to the norm in the US. Please
be sure to list all special medical conditions you may have. _____________________________________________________________________
Blood Type___________
Special Diet or Foods_______________________________________________________________
Check any of the following that are applicable:
Diabetes________ Epilepsy__________ Allergies_______________________________________
Other health concerns, such as bad back, trick knee, etc. (give
details_________________________________________________________________________
____________________________________________________________________________
Loss of Consciousness (explain and give date(s)____________________________________________
_____________________________________________________________________________
Check if Corrective (____) or Contact Lenses (____) Date of last
physical examination_____________
Any other pertinent information: _______________________________________________________
______________________________________________________________________________
Conditions
As a team member (hereafter Participant)
of the Baga Gazaryn Chuluu Survey project, I will adhere to the regulations
and maintain a standard of good conduct. The Center for the Study
of Eurasian Nomads (hereafter Sponsor) and director of the excavations
(hereafter Director) reserves the right to require a Participant to
withdraw at any time if conduct or behavior jeopardizes the welfare
of any participant or the fulfillment of the objectives of the project.
Additional travel costs due to early dismissal will be the entire
responsibility of the Participant. It is understood that the Participant
will assume all responsibilities, financially or otherwise, for any
illness or injury which might occur during the expedition. Emergency
transport, medical or hospitalization costs resulting from illness
or accident during the expedition are the responsibility of the Participant
receiving such care. In cases where the Director, in consultation
with the Participant and local medical authorities, considers it necessary,
a Participant will be sent home or hospitalized. The Director will
make every effort to ensure that an ill or injured volunteer receives
proper medical attention. The Participant is aware that while taking
part in this project, certain exposure to risks may occur. Exposure
may include but not be limited to: accident and/or sickness without
readily available medical facilities, the forces of nature, travel
on the ground and in the air, and others. In consideration of the
right for the Participant to engage in this project, he or she assumes
all of the risks involved and agrees to indemnify and hold the Sponsor
and the Director of the project and his Associations harmless for
any and all liability that may arise in connection with travel to
and from the archeological site, to any of the excursions, and while
engaged in any activities. I have read and fully understand and accept
the conditions for participating in this archaeological expedition.
Signature________________________________________________________________________
Print name_________________________________________________Date___________________
|
