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FIELDWORK OPPORTUNITIES 2005

APPLICATION FOR GOLDEN HILLS KHAZAR FORTRESS

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Center for the Study of Eurasian Nomads
Golden Hills Khazar Fortress
2158 Palomar Ave.
Ventura, CA 93001 USA
Phone: (805) 653-2607 * FAX: (805) 653-2607
e-mail: jkimball@csen.org


APPLICATION FOR

SUMMER 2005 EXPEDITION

GOLDEN HILLS KHAZAR FORTRESS

 

Minimum Age: 18 years

TAX DEDUCTIBLE CONTRIBUTION (If paid to CSEN)

Each Session $1100

First Session: June 19 - July 10, 2005

Second Session: July 15 - August 5, 2005

 

CONTRUBUTION DUE DATES

$300 due with application by April 15, 2005

Final contribution: $800 due by May 10, 2005

 

The essential official visa for the excavation requires approximately four weeks to obtain.

Thus, deadlines are firm.

No Invitation for a Visa will be issued until all contributions are paid



REFUND POLICY: If you are not accepted, your deposit will be refunded. If you are accepted and you withdraw more than 60 days before the beginning of the first session, 50% of your deposit will be refunded. If you withdraw after 60 days before the beginning of the first session, no refund will be made. However, the deposit remains tax-deductible


Personal Information


Name________________________________________Birthdate______________________

Address___________________________________________________________________

Mailing Address if different from above _____________________________________________________________________________


Home phone (_____) ______________ e-mail address ___________________________


Social Security number_________________S ex_____ Height_______ Weight_______

Passport number_____________________________ Expires______________________

INCLUDE A XEROX COPY OF THE FIRST TWO 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___________________________


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


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
_________________________________________________


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 Golden Hills 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_____________

 

Return Application to: Center for the Study of Eurasian Nomads, Golden Hills Khazar Fortress Excavation, 2158 Palomar Ave., Ventura, CA 93001, USA