2019 SUMMER PRE-COLLEGE PROGRAM
June 3 – July 26, 2019 WHAT IS THE PRE-COLLEGE PROGRAM?
COURSES OFFERED
THIS EIGHT WEEK INTENSIVE PROGRAM IS INTENDED FOR UNDERGRADUATE -BOUND
Summer Session 1 ENG 075: Advanced Reading (3) HUM 199: College Success (3) Summer Session 2 ENG 085: Communication Workshop (3) MTH 100: Intermediate Algebra (4)
HIGH SCHOOL OR GED STUDENTS WHO ARE
Total Credits: 13
INTERESTED IN COMPLETING PRECOLLEGE
TUITION & FEES
CLASSES DURING THE SUMMER AND BEGIN
COLLEGE -LEVEL COURSES DURING THE FALL SEMESTER.
THE PROGRAMS ARE OFFERED AT THE TSAILE, SHIPROCK AND TUBA CITY CAMPUSES.
$55.00 Per Credit Hour $20.00 Technology Fee $25.00 Activity Fee
12 Credit Hours (full-time) X $55.00 Per Credit hours = $660 + $45.00 Fees = $705.00 Total
ROOM & BOARD +
PROGRAM REQUIREMENTS Acceptance Letter from Dine College Complete Program Application www.dinecollege.edu Complete 2018-2019 FAFSA ACT/SAT or Accuplacer Test Scores Meet with Advisor and Register for Pre-College Program Courses
$390.00 Room for 10 weeks (M-TH) $600.00 Meals for 10 weeks (M-TH)
$990 Total TUITION & FEES
ROOM & BOARD
TOTAL COST OF PROGRAM
$705.00
$990.00
$1,695
Application Deadline: MAY 27, 2019 Tsaile Campus: Fredi Tapaha, Special Projects Coordinator │
[email protected] │928-674-6861 Shiprock Campus: Marlencia Chee, Faculty │
[email protected]│505-368-3662 Tuba City Campus: Phyllis Begay, Tuba City Center Director │
[email protected]│928-283-5113
2019 Summer Pre-College Program June 3 – July 26, 2019 This eight-week day program is designed to give recent high school graduates and General Education Diploma recipients an opportunity to complete developmental courses during the summer of 2019 at Diné College. Participants will enroll in six credit hours during summer session I and seven credit hours during summer session II. At the end of the summer, students will accumulate 13 credit hours and will be ready for college-level reading, English and Math courses in fall semester 2019. The program will run Monday through Friday. Students will participate in college courses, personal development workshops, tutoring sessions, study groups, and social events organized by Diné College professionals. In addition, students will work with professors, peer mentors, and the Student Success staff to successfully complete the program. The Summer Pre-College Program will be partially funded by the Title III grant. Day students will be responsible for their own transportation to and from the college campus. Students will be accountable for their tuition and fees ($705.00) for the 8-week period. If the student decides to stay in the dorm at the Tsaile Campus, he/she will be responsible for room and board fees ($990.00; 10 weeks). All program participants will be required to complete a FAFSA (Free Application for Financial Student Assistance) to cover tuition and fees and other expenses incurred. We would like to have all programs participants to continue their studies at Diné College after they complete the program; however, this is not a requirement. Program participants can attend any college or university of their choosing after they complete the program. Note: the developmental courses will not transfer to a college or university, but those courses will be used to place a student in the appropriate college-level reading, English and Math courses.
ELIGIBILITY Participants must satisfy the following criteria: (1) Will graduate from an accredited high school in spring 2019. Home-schooled students and GED recipients must have received a diploma prior to the start of the program. (2) Have a strong desire to begin college. (3) Plan to enroll in an institution of higher education in fall semester 2019. (4) Have an overall GPA of 2.00 or above (2.50 preferred, but not required). PROGRAM APPLICATION CHECKLIST Completed Application Form Response to Personal Insight Questions Waiver of Liability, Assumption of Risk, and Indemnity Agreement Photo/Video Release
Diné College 2019 Summer Pre-College Program June 3 –July 26, 2019
PROGRAM APPLICATION Please submit all documents to be considered for the program. Space is limited and you will be notified. If you have any questions, contact Fredi Tapaha by phone at (928) 724-6861 or by email at
[email protected]. Please submit all documents to the Admission’s Office in Tsaile or the Shiprock Branch or mail your complete application to the following address:
Summer Pre-College Program Diné College 1 Circle Dr., Route 12 Tsaile, AZ 86556 Deadline: May 27, 2019
Student Information: Name (First):
(Middle):
(Last):
Mailing Address: City:
State:
Zip:
Phone: (_____) ___________________________ E-mail: Date of Birth:
Age:
Male:
Female:
Other:
Tribal Affiliation: _________________________ High School Name: Grade Point Average: Program desired (Choose one):
T-Shirt Size (Circle one): Small Tsaile—Day
Medium
Large
Tsaile—Residential (Dorm)
College plan to attend:
Name:
Relationship:
Mailing Address: City:
State:
Phone Number: (_____)
Email:
Zip:
Person to contact in case of an emergency:
Phone Number: (_____)
Relationship:
XX-Large
Shiprock—Day
Anticipated Start Date (Month/Year):
Parent/Guardian Information:
Name:
X-Large
Personal Insight Questions:
1. What are several goals you have set for yourself and have accomplished thus far? (At least 100 words)
2. Describe the most significant challenge you have faced and identify the steps you have taken to overcome that challenge. (At least 100 words)
3. Why should you be considered for the Summer Pre-College program at Diné College? (At least 100 words)
Media Release Form For valuable consideration, I hereby irrevocably consent to and authorize Diné College the use and reproduction of any and all photographs taken of me at a time period of a campus event, travel, workshop, conference, or public gathering for the purpose of academic publication, institutional reporting, or visual data collecting, without further compensation to me. All negatives, positives, or digital capture files, together with the prints and video(s) shall constitute the property of Diné College, solely and completely. Name of Student (Print Name):
Address:
City:
State:
Phone:
Email:
Zip:
******************************************************************************
Signature of Student:
Date:
Signature of Parent/Guardian of Minor:
Witnessed by (Print Name):
Signature of Witness:
Date:
ASSUMPTION OF RISK, WAIVER OF LIABILITY & INDEMNIFICATION AGREEMENT This Agreement must be completed in order to participate in the Summer Pre-College Program. Participant (print full name): Cell Number :( )
Email address:
Program/Course Activity (PCA):
2019 Summer Pre-College Program
Location (Circle one): Tsaile
Shiprock Tuba City
Dates: ______June 3 – July 26, 2019_______
I, the undersigned, am either the Participant named above or the parent or legal guardian of the Participant (minor; under 18 years of age) named above. I am familiar with the curriculum and the activities associated with this Program/Course. TERMS AND CONDITIONS I will participate (or authorize the Participant to participate) in the above program at the Diné College. I understand that such participation can include foreseeable and unforeseeable risks and other hazardous activities inherent in the PCA which may expose the participant to illness, injury, or death. Participant or Parent/Guardian freely and voluntarily participate or allow participation in the PCA with knowledge of the danger involved and hereby agrees to assume and accept any and all risks of illness, injury, or death. WAIVER, RELEASE AND INDEMNIFICATION Participant (or Parent/ Guardian of Participant) understands and acknowledges that the Diné College (“College”) is not an insurer of Participant’s behavior, actions or participation in the PCA. The College assumes no liability whatsoever for personal injuries or property damages to Participant’s property or to third persons arising out of participation in the PCA. Participant or Parent/Guardian hereby agrees to release, waive, covenant not to sue, indemnify and hold harmless the College, and all of their officers, employees and agents (collectively the “Releasees”) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage to any property belonging to Participant arising out of or related to participation in the above named PCA, and excepting only such loss, damage or injury as may be caused by the sole negligence of any Release. Participant or Parent/Guardian of Participant agrees that the site of any lawsuit arising out of or related to participation in the PCA shall be the Navajo Nation and that this Agreement will be governed by and construed in accordance with the laws of the Navajo Nation, without application of any principles of choice of law.
Participant does not have any medical conditions that would prevent participation in the PCA. Participant has adequate health insurance to cover the cost of treatment in the event of any injury. Participant shall pay any attorney fees or costs incurred by the College in enforcing this Agreement.
If any portion of this Agreement is invalid by a court of law, then it is agreed and intended that all the remainder shall, not withstanding, continue in full force and effect.
PARTICIPANT (OR PARENT/GUARDIAN OF PARTICIPANT) HAS CAREFULLY READ THESE TERMS AND FULLY UNDERSTANDS THE CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN PARTICPANT OR PARENT/ GUARDIAN OF PARTICIPANT AND THE RELEASEES AND SIGNS IT OF HIS OR HER OWN FREE WILL. I am signing the Agreement for myself as a Participant. I acknowledge that I am eighteen (18) years of age and that I understand the terms of this Agreement. I also acknowledge that this Agreement shall bind my heirs and personal representatives.
Participant Name (Print)
Signature
Date
I am signing this Agreement on behalf of the Participant (a minor). I acknowledge that I am the Parent/Guardian of the Participant and that I understand the terms of this Agreement. I also acknowledge that these terms shall bind my heirs and personal representatives and the heirs and personal representative of Participant.
Legal Parent/Guardian Name (Print)
Signature
PARTICIPANT HEALTH INSURANCE INFORMATION Health Insurance Provider Health Insurance ID No. Health Insurance Address Health Insurance Phone# Primary Named Insured
Date
