By clicking the links below, please complete and submit all of the required forms by Wednesday, November 19th, 2008. Please print each signed form for your records.
1. Academic Work/Personal Conduct Form: Reminds students that R-MC can exclude individuals from participation in a study/travel course on account of unsatisfactory academic work or personal behavior and that students can be removed from a course due to disruptive behavior.
2. Emergency Contact Information Form: Provides information used to contact a student’s family/guardian in case of emergency.
3. Emergency Medical Information Form: In case of a medical emergency in which the student is unable to communicate, this form may be used to provide pertinent medical information to medical personnel. Students are encouraged but not required to provide the information requested on the form.
4. General Release from Liability Form: Required of all enrolled students to sign to agree that participation in a J-term study/travel course is not required as part of the Student’s academic or other responsibilities at the College and that their participation in the Study/Travel Course is voluntary and solely for the their benefit.
5. Mandatory Medical Insurance Form: This form contains information regarding the Randolph-Macon College’s mandatory insurance policy. If interested in purchasing additional insurance to cover things such as trip cancellation, the student and/or guardian must take responsibility for enrolling.
6. Informed Consent/Privacy Act Waiver Form: Grants Randolph-Macon College permission to communicate information about students to their parents or guardians or, if married, to their spouses, while students are participating in a study/travel course.
7. Privacy Act Waiver for U.S. Department of State Form: Waives a student’s rights under the Privacy Act, thereby authorizing the U.S. Department of State to release information about a student to Randolph-Macon College. Without a signed Privacy Act waiver, the only information the Department of State will communicate to R-MC about a student is whether they have been able to contact the student. In case of an emergency overseas, the assistance of the Department of State may be desired or necessary. Therefore, the college requires this waiver and does so in the interest of students and their families.
NOTE: The Judicial Affairs Form, which used to be called “Dean of Student form,” should be submitted upon request from the instructor. This form authorizes release of information from a student’s conduct record to the following: Office of International Education and student’s J-term study/travel course instructor(s).