The First Heidelberg Summer Seminar in Ancient Studies.

Life on the Fringe.

July 23rd to August 3rd 2007.

www.summerschool.uni-web.org

Enrollment and Payment Form

Please complete both parts of the form, sign it, and return it to the address below. Alternatively you may e-mail it to: SummerSchool@uni-web.org

Philip Kiernan

Institut für klassische Archäologie

Marstallhof 4
69117 Heidelberg

GERMANY

Part 1: Your Info.

Full Name:

Date of Birth:

Citizenship:

Mailing Address:

E-mail Address:

Telephone:

Emergency Concact Info: (please give name, telephone etc)

University Affiliation:

Department:

Current Degree Programme:

Date of Arrival in Heidelberg (if known)

Do you have a disability or other condition that we should know about?

Other Comments?

Waiver of Liability

Please read and sign the following statement:

I hereby agree to maintain accident and health insurance in force and effect for the entire duration of my participation in the program. I further certify that, to the best of my knowledge, I am in good health and physically capable of undertaking an intensive program of foreign study.

I acknowledge that participation in an exchange program involves some risks of injury, illness, or loss of personal property. I agree to release and forever discharge the University of Heidelberg, its staff, the Institute for Ancient Studies, Philip Kiernan and Nora Brügmann, from any and all claims, demands, rights and causes of action of whatever kind or nature, arising from and by reason of any and all known and unknown, foreseen and unforeseen bodily and personal injuries, including death, damages to property and the consequences thereof, resulting from my participation in the exchange program described above.

I have read the above statements carefully before signing. Further, I understand that this Release and Waiver of Liability shall be effective for a period of one year from this date.

_________________________________________ ________________________________ _____________

(signature)	(please print name)	(date)

Part Two. Fees and Payment:

Accommodation Fees: Please chose and tick one. All prices include a night in a youth hostel in Trier. Please tick one.

Youth Hostel.	300 Euros

Camping, Tent.	125 Euros

Camping, Cabin.	175 Euros

I will arrange my own accommodation in Heidelberg,

but need a youth hostel for the trip to Trier	30 Euros.

PLUS

General Fees:

(Includes tuition, materials

transport to sites and entrance fees)	250 Euros

TOTAL:

Method of Payment: Upon acceptance, applicants will be sent the account number of the Institute for Classical Archaeology. The simplest method is to use a bank transfer to send the money. Cheques and Banker’s drafts will also be accepted, but may incur a banker’s fee if in a currency other than euros.

The First Heidelberg Summer Seminar in Ancient Studies

Philip Kiernan

2007-04-07

University of Mannheim