*三週互動式英語課程
*至美國2014NBA總冠軍聖安東尼馬刺隊主場觀賽
*圍城十三天阿拉莫美墨戰役(獨立革命)古蹟參觀
*全美第二大 Outlet Mall 購物
期間：2016年1月24日至2月13日(3週)
預估團費：新台幣14萬元
(包含機票、學費、教材費、課外活動費、課外活動交通費、
接機費、住宿費、餐費、海外旅遊險，當地學生保險)
*所含機票費預估5萬元，實際以旅行社開票價格為主
達10人出團
報名時間：
即日起至2015年11月30日(一)到國際處報名
可 至 國 際 事 務 處 或 E m a i l 索 取 報 名 表
國 際 及 兩 岸 事 務 處 - Joyce
0 7 - 6 5 7 7 7 1 1 # 2 0 9 4
h h s u @ i s u . e d u . t w
美國德州聖道大學
冬令營招生中
期間：2016年1月24日至2月13日(3週)
WEEK 1
Sunday
24-Jan
Monday
25-Jan
Tuesday
26-Jan
Orientation & ELS
Placement Test, Campus
tour
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
Thursday
28-Jan
Friday
29-Jan
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
Brunch at Marian
11:00am - 2:00pm
LUNCH at the Marian Hall
12:30 - 1:30 p.m.
Mother House Chapel
2:00 - 2:30pm
San Antonio Aquarium
3:00 - 5:00pm
Saturday
30-Jan
Free Time
Arrival & Check In
Welcome Dinner
6:00 - 8:00pm
Wednesday
27-Jan
BREAKFAST
7:30 - 8:30 a.m.
Walmart
2:00 - 3:30pm
Denman Estate
2:00 - 3:00pm
Shopping center:
Best Buy, Ross, etc.
2:30 - 4:30pm
La Cantera Mall
3:00 - 6:00pm
Free Time
Sports Activties
2:00 - 5:00pm
DINNER at the Marian Hall
6:00 - 7:00 p.m.
Astro Bowl
7:30 - 9:00 pm
UIW Basketball
4:30 - 6:30pm
DINNER at the
Marian Hall
6:30 - 7:30 p.m.
Movie Night
7:30 - 9:00 pm
Mother
House
Chapel
WEEK 2
Sunday
31-Jan
Monday
1-Feb
Tuesday
2-Feb
Wednesday
3-Feb
BREAKFAST
7:30 - 8:30 a.m.
Breakfast at ICC
8:30 - 9:30am
Depart 10:00am
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
Texas State History
Museum
Movie & Tour
11:00am- 1:00pm
Lunch in Café
1:00- 2:00pm
Texas Capitol Tour
2:30- 3:30 pm
Depart 4:00pm
DINNER at the Marian
Hall
6:00 - 7:00 p.m.
ELS Classes
9:00am - 12:00pm
Thursday
4-Feb
Friday
5-Feb
Breakfast at ICC
8:30 - 9:30am
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
LUNCH at the Marian Hall
12:30 - 1:30 p.m.
Target & Shopping
Center
2:00 - 4:00p.m.
Tour of Pharmacy
School 2:00 - 3:00pm
DINNER at the Marian
Hall
5:00 - 6:00 p.m.
Tour of Optometry
School
3:30 - 4:30pm
San Antonio
Museum of Art
2:30 - 4:30pm
San Antonio Zoo
2:30 - 5:00pm
Depart at 10:00am
Downtown San Antonio:
Alamo Plaza/ Rivercenter
Mall
(2:00 - 4:00pm)
Riverbarge Tour
(4:00- 5:00pm)
DINNER at the Marian Hall
6:00 - 7:00 p.m.
Spurs Basketball game
vs. Orlando Magic
7:00 - 10:00pm
Saturday
6-Feb
San Marcos
Shopping
(Lunch on your own)
11:00am - 6:00pm
Dinner at Mr. Gatti's
7:00 - 8:00pm
WEEK 3
Sunday
7-Feb
Monday
8-Feb
Tuesday
9-Feb
Wednesday
10-Feb
Lunch at Big Lou's
Pizza
1:30 - 3:30pm
Walmart
4:00 - 5:00p.m.
Friday
12-Feb
BREAKFAST
7:30 - 8:30 a.m.
Breakfast at ICC
8:30 - 9:30am
Mission Espada
10:00 - 11:00am
Mission San Jose
11:00am -12:00pm
Mariachi Mass at
Mission San Jose
12:30 - 1:30pm
Thursday
11-Feb
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
ELS Classes
9:00am - 12:00pm
Lunch at Marian Hall
Nursing School Tour
2:00 - 3:00pm
North Star Mall
2:00 - 6:00pm
Physical Therapy
tour
Witte Museum
4:30 - 6:00pm
DINNER at the Marian Hall
6:00 - 7:00 p.m.
Natural Bridge
Caverns
2:00 - 5:00pm
Saturday
13-Feb
San Antonio
Spurs
Breakfast at ICC
8:30 - 9:30am
ELS Classes
9:00am - 12:00pm
Last Day of ELS Classes
9:00am - 12:00pm
12:30 - 1:30pm
Admissions
Presentation
2:30 - 3:00pm
UIW Bookstore
3:00 - 4:00pm
Sports Activities
4:00 - 6:00pm
Last minute shopping:
Quarry Market
2:30 - 4:30pm
Pack for Departures
5:00 - 6:00pm
Farewell Dinner- Golden
Corral
6:00 - 8:00pm
Departure
Downtown
San
Antonio
Language & Cultural Program - 2016
Housing
HOUSING
Throughout their stay, students stay at dormitory rooms for students. Each room has a bed, desk,
chair, chest of drawers and closet space. Linen, towels, and soap are supplied for each room.
Housekeeping comes once a week for a full cleaning of room and 3 times a week to exchange
towels.
All halls are monitored by Resident Assistants. The RA’s are there to assist with any lockouts or any
other problems the students may need help with during their stay.
The occupant will be held responsible for any damages and/or accidents that pertain to the
condition of the facility during time of stay. Fees may be charged and billed to the occupant
accordingly.
Keys
 All students are given 1 key and 1 access card. The key opens up their bedroom and the
access card grants them access to the dormitory. If lost there is a charge for each.
Replacement of an access card to the building is $20. Replacement of room key is $50.
Students must pay this at the time it is lost.
 Lockouts – Students will not be charged the first 2 times they are locked out of their room.
After the 2nd time the student will be charged $15 per lockout. It is important for the
students to keep their keys with them at all times.
Laundry Facilities
o Each floor is equipped with washer, dryer, and laundry detergent. Machines take
quarters only and it is .75 cents per load.
Language & Cultural Program - 2016
Personal Information
1. Applicant Information
Full Legal Name as it appears on passport or birth certificate
(use all capital letters for your FAMILY name)
Preferred Name
Gender
O Male
O Female
Home Address – Street
City
State/Province
Postal Code
Home Phone
Moblie Phone
E-mail
Country
Place of Birth (City, State/Province,
Date of Birth (e.g. 01/Jan/1999)
Country)
Citizen of (Country)
Passport Number
Country of Passport
Passport Expiration Date:
2. Parent/ Legal Guardian Information
Full Name of Father/Legal Guardian
Full name of Mother/Legal Guardian
Address - Street
Address - Street
City
State/Prov.
City
State/Prov.
Postal Code
Country
Postal Code
Country
E-mail
Home Phone
E-mail
Mobile Phone
Home Phone
Mobile Phone
Language & Cultural Program - 2016
Personal Information
3. Personal Background
Blood Type
Do you have any dietary restrictions?
O Yes
O No
If yes, please explain (e.g., vegetarian, food allergies):
List any/all medical conditions (e.g.: asthma, pacemaker, etc.):
List all food, drug or pet allergies:
List any/all over-the-counter and/or prescription drugs taken regularly:
Languages
4. Native Language:
Non-Native Language(s)
Years
Studied
Personal Preferences
Favorite Pass time and/or Hobbies:
Sports or Extra Curricular Activities:
Additional Information:
Proficiency (indicate Poor, Fair, Good, or Fluent
Speaking
Reading
Writing
Language & Cultural Program - 2016
AUTHORIZATION AND MEDICAL CONSENT OF PARENT(S) OR LEGAL GUARDIAN(S)
I, (name) _____________________________________, do hereby solemnly swear that I am the parent or legal guardian of
(child name) ____________________________________, a minor child (hereafter “the minor”), and have legal custody of the
minor child.
I grant my authorization and consent for the Residence Life staff of Incarnate Word High School, St. Anthony’s Catholic High
School, and University of the Incarnate Word (hereafter “Supervising Adult”) to administer general first aid treatment for any
minor injuries or illnesses experienced by the minor. If the injury or illness is life threatening or in need of professional
emergency treatment, I authorize the Supervising Adult to summon any and all professional emergency personnel to attend,
transport, and treat the minor and to issue consent for any X-ray, anesthetic, blood transfusion, medication, or other medical
diagnostic, treatment, or hospital care (including surgery) deemed advisable by, and to be rendered under the general
supervision of, any licensed physician, surgeon, dentist, hospital, or other medical professional or institution duly licensed to
practice in the state in which such treatment is to occur.
I agree to assign the benefits of personal coverage of medical insurance for the minor to the appropriate providers of his/her
medical care. In the event that appropriate medical coverage under my medical insurance plan is unavailable, insufficient, or
denied with respect to the treatment or services provided to the minor, I agree to assume all financial liability and
responsibility for all expenses and costs associated with said transportation and/or treatment of his/her illness or injury. Also,
I authorize the hospital, attending physician, or other health care specialist administering the treatment to release pertinent
information to the insurance company assuming coverage for the same.
In consideration of the Residence Life staff of Incarnate Word High School, St. Anthony’s Catholic High School, and University
of the Incarnate Word caring for the minor and agreeing to intervene on my behalf to provide or make arrangements to
provide medical assistance to him/her as needed, I agree to release and indemnify the University of Incarnate Word, Incarnate
Word High School, and St. Anthony’s Catholic High School, including their respective trustees, directors, officers, faculty, staff,
employees, servants, and other agents and assigns from all liability and responsibility for any claims, demands, actions or
other proceedings for any personal injury, accident, damage, expenses, or other loss caused, suffered or incurred by the minor
or any other person or entity arising out of his/her/its participation in the boarding program.
I acknowledge that I have read and understand the above statements and that if I am unable to do so, for whatever reason, I
have had them read to me and I am confident that the individual so doing has read and/or translated the statements
truthfully and in their entirety.
It is understood that this authorization is given in advance of any such medical treatment, but is given to provide authority and
power on the part of the Supervising Adult in the exercise of his or her best judgment upon the advice of any such medical or
emergency personnel.
I, the undersigned, hereby specifically authorize the University of Incarnate Word, St. Anthony’s Catholic School and Incarnate
Word High School Residence Life staff and/ or any authorized member of its staff or duly affiliated consultant to provide care
and treatment to the student and to arrange for routine medical needs and emergency treatment as deemed necessary.
A photocopy of this authorization shall be as valid and may be accepted as the original.
This authorization shall be effective as of ________________________, 20 ____.
Parent/Guardian Signature ________________________________________ Date _____________
Language & Cultural Program - 2016
Accident & Sickness Insurance Overview
INSURANCE
All students participating in the program are covered under our International Insurance. If a student is
sick and needs to be taken to the doctor a UIW staff member will take the student first to our oncampus nurse or off campus clinic. The following is a list of the Medical Expense Benefits:
•
Maximum benefit: $100,000 per Injury and Sickness
•
Deductible: $25 per Injury and Sickness
•
$100 Co-payment per Hospital Admission
•
Medical Emergency Expenses: incurred in a hospital emergency room, surgical center or clinic$250 co-payment per Visit
•
Diagnostic X-rays: when prescribed by the attending Physician- $25 co-payment per Visit
•
Laboratory Procedures: when prescribed by the attending Physician- $25 co-payment per Visit
•
The Covered Person is responsible for a $10 co-payment per generic prescription, $15
co-payment per brand name prescription or $30 co-payment for multi-source prescription
If for some reason your son/daughter needs to be taken to the hospital. The insurance covers 80% of all
hospital medical bills.
Please initial the following statements and sign below stating you agree to the UIW Insura-nce plan.



_____ I understand that if my son/daughter gets sick and needs to see a doctor, there are
different co-payments and deductibles that apply.
_____ I understand that if my son/daughter needs medication he/she must pay the copayment and he/she may need to pay an additional cost of the prescription once the
Insurance contacts the University of the Incarnate Word for billing.
_____ I understand that if my son/daughter must be taken to the hospital the insurance will
cover 80% of the bill if taken to an in-network hospital or 60% if taken to an out-of network
hospital.
This authorization shall be effective as of ________________________, 20 ____.
Parent/Guardian Signature ________________________________________ Date _____________