FIELDWORK OPPORTUNITIES 2006

PARTICIPANT APPLICATION

Baga Gazaryn Chuluu Index Page

Home

Center for the Study of Eurasian Nomads
Baga Gazaryn Chuluu Survey
2158 Palomar Ave.
Ventura, CA 93001 USA

Phone: (805) 653-2607 * FAX: (805) 653-2607
e-mail: jkimball@csen.org

APPLICATION FOR
SUMMER 2006 EXPEDITION BAGA GAZARYN CHULUU SURVEY

Applicant's Name: _____________________________________

TAX DEDUCTIBLE CONTRIBUTION PER SESSION

APPLICATION AND CONTRIBUTION DEPOSIT DEADLINES

First Session: $300 due with application no later than April 1, 2006

Second Session: $300 due with application no later than May 1, 2006

FINAL CONTRIBUTION DEADLINE

First Session Due May 1, 2006

$1050 for students

$1250 for non-students

Second Session Due by June 1, 2006

$1050 for students

$1250 for non-students

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 45 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.

Please check the session(s) for which you are making application
First Session (First choice__________) (Second choice ________)
Second Session (First choice_________) (Second choice _________)

If you are applying s a student, please submit evidence of enrollment.

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.

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_________________________Sex________ 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.You must bring any prescription or over the counter medications hat you require.

LIST ANY MEDICAL CONDITION THAT YOU HAVE OR HAVE HAD IN THE PAST FIVE YEARS

Blood Type___________ Special Diet or Foods__________________________________________________________________________________

If you dietary requirements are different than noted in the information provided on the Web pages associated with this application, you should plan on bringing any required (or desired) 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 archaeological or other activities.

 

I have read and fully understand and accept the conditions for participating in this archaeological expedition.


Signature____________________________________________________________________

Print name_________________________________________________Date___________________


Mail Application with Deposit to:

Center for the Study of Eurasian Nomads

Baga Gazaryn Chuluu Excavation

2158 Palomar Ave.

Ventura, CA 93001, USA