Ceiba Field Course Enrollment Form

We’re so excited that you’ll be joining us abroad!

Congratulations on your acceptance to a Ceiba study abroad program! The completion of this form is a requirement for any short field course in summer or winter with The Ceiba Foundation. We require that you fill out this form completely in order to confirm your enrollment in the program by the deadline indicated in your acceptance letter. Please note, you cannot save this form so make sure to gather all information needed before you fill it out. All fields marked with an asterisk are required. Please see the enrollment checklist for other steps to prepare for your trip!

  • Personal Information

    Fields marked with an asterisk (*) are required.
  • If unavailable, please let us know when your passport arrives.

  • Diet and Health Information

    Please be as complete as possible. Complete health information allows us to offer you the best possible service at field sites and provide you with appropriate care in the event of a medical emergency.
  • Please describe any medical conditions that course staff should know about in the event of an accident or medical emergency (e.g., asthma, bleeding, colitis, diabetes, epilepsy, heart disease, hernia, high blood pressure, joint injury, kidney disease, mental/emotional problems, neck/back pain, rheumatic fever, ulcer, or other):
  • Enter "none" if you do not take any prescription drugs.

  • Emergency Contact Information

    Please provide complete information about who we should contact in the event you are involved in an emergency situation during the program.

  • Alternate Emergency Contact

  • Certification and Signature

    I certify that information provided on this form is true and correct.
  • By entering your name below, you agree to the statement above.
  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Thanks for enrolling!

You can already start packing your bags, charging your camera, and polishing your binoculars!  But first, make sure that you have a valid passport: US law requires that your passport be valid for at least six months beyond your return.  If you need to renew your passport, or order your first one, it’s best to get started right away.