UCD-Young Scholars Program Acceptance Confirmation Form

UCD-Young Scholars Program

Acceptance Confirmation Form

Dear Applicant,

It is with great pleasure that I inform you that your application to the 2016 UC Davis -Young Scholars

Program at the University of California, Davis was

approved

by the selection committee. We

sincerely hope you will be able to accept this invitation to participate in this very fine program.

Evidence over the past 53 years clearly indicates that the program markedly influences participants'

future plans.

Please complete and return the attached acceptance confirmation form with your decision

along with the forms below. Please mail the original copies of all forms so that they arrive in my office

as soon as possible but, no later than the close of business on Friday, April 29, 2016.

Please email

me at [email protected] by Monday, April 25

or sooner to confirm your receipt of this letter

and attached packet of forms and indicating your plans prior to sending the reply.

It should be

understood that acceptance, accompanied by a non-refundable deposit, obligates you to attend for

the full duration of the program from June 19 through July 30, 2016 without taking time out for other

activities. Information about the non-refundable deposit, the performance guarantee and other

program costs are included on the confirmation form and in the Acceptance Packet Forms. If your

requested a fee reduction at the time of application, you will receive a separate email with that

information.

After accepting, it is also important that you log into your account on our web site and complete

the online personal information/ Research Interest Form:

http://ysp.ucdavis.edu/application/research

Specifically, please enter your responses in the Research Areas of Interest section.

It is

imperative that you provide a rating for each area on the list.

The scale for these ratings is 1=

Area of Highest interest to 6 = area of lowest interest. Once you have completed your rankings,

please be sure to enter your initials in the box provided.

If you are unable to accept our invitation, please call or email me at the above numbers by

April 25th so that I can offer your position to one of the students on the alternate list.

I am looking forward to hearing of your decision and to meeting you on June 19

.

Sincerely,

J. Richard Pomeroy, Director

UCD Young Scholars Program

UCD-Young Scholars Program

Acceptance Confirmation Form

_______________________________ _______________________

Applicant Name

User ID#

__________ I accept this invitation to participate in the UCD-Young Scholars Program. Acceptance

must be accompanied by a

non-refundable

deposit of $2200 ($2175 + application fee you paid) in

the form of a money order, cashiers check, or online credit card payment (No personal checks for the

non-refundable deposit can be accepted.) Information about using the online credit card payment

system is included in these acceptance package forms. Cashiers Checks should be made payable to

UC Davis -Young Scholars Program or UCD-YSP. The balance of $4000 is due by the close of

business, Monday, June 1, 2016.

PLEASE INCLUDE A RECENT PHOTOGRAPH OF YOURSELF IF YOU ARE ACCEPTING OUR

INVITATION.

__________ I decline this invitation to participate in the Young Scholars Program.

Please state your reasons for choosing not to participate

_____________________________

Student signature

I give my permission for my son/ daughter/ ward to participate in the UC Davis Young Scholars

Program

______________________________

Parent /Guardian Signature

Please return this form no later than the close of business, Friday April 29, 2016 to:

J. Richard Pomeroy, Director

UC Davis Young Scholars Program

School of Education

University of California

One Shields Avenue

Davis, CA 95616-8579

Acceptance Packet Forms

Checklist

Updated 4/22/16- JRP

Thank you for downloading the Acceptance Packet Forms. Please be sure to complete and sign all forms and return them to the address below with your non-refundable deposit, housing

security/cleaning deposit check and your Acceptance Confirmation. All forms and confirmation of the non-refundable security deposit must be returned by April 29, 2016.

J. Richard Pomeroy, Director UCD-Young Scholars Program

School of Education, University of California One Shields Avenue

Davis, CA 95616-8579

• Program Costs and Payment Information • Online Payment Instructions

• Payment Coupons • Medical Form • FERP Rights Form

• UCD Young Scholars Expectations • Acceptable Use Policy

• Social Media Policy

• UCD-YSP Photo Release Form • Survey Consent Form

• Bodega Bay Marine Lab Waiver Form

• Project Checklist for Minors Performing Research in Laboratories

• Frequently Asked Questions for International Students (Non US Citizens or non-permanent residents.

The Acceptance Packet Forms include the Payment Information and Payment Instructions. These forms need not be returned.

UCD- YSP Payment Information

2016

Program Costs

Congratulations on your acceptance to the 2016 UCD-Young Scholars Program. The cost for the program for the summer of 2016, including 5 units of University group study credit, is $6200*. This fee covers room and board, weekend field trips, and all program costs for the duration of the program (June 19- July 30, 2016). This amount is broken down into a $2200* NON-REFUNDABLE Deposit ($2175 + $25 application fee) and balance of $4000. The non-refundable deposit MUST be paid in the form of a money order, certified cashiers check or online credit card payment. NO PERSONAL CHECKS CAN BE ACCEPTED FOR THE NON-REFUNDABLE DEPOSIT Please use the enclosed payment coupons for all payments. If you pay online, please include a copy of your payment confirmation including the transaction number. In addition to the $2200 non-refundable desposit, there is a $200, fully refundable housing security deposit due with your first payment and acceptance package forms. Please be sure that the housing deposit is in the form of a SEPERATE PERSONAL CHECK. Assuming that no keys are lost, no damage is done to the dorm room, and all library materials have been returned, this deposit will be returned to you. Your non-refundable deposit and housing security deposits are due by the close of business on April 29, 2016. Payment in full is due by the close of business, June 1, 2016. *If you requested a fee reduction at the time of your application, please adhere to the dollar amounts shown in your award letter email.

Performance Guarantee

If for some reason you must withdraw from the program after paying your non-refundable deposit, but prior June 19, 2016, every effort will be made to fill your place in the program. If a candidate can be found to take your place (secured by a non-refundable deposit) at the full fee level, your deposit will be returned minus a $500 refund fee. If no one can be found to fill your place, the non-refundable deposit will be forfeited.

University Credit

All students will receive 5 units of University group study credit. The cost for these credits is included in the total cost of the program.

Bicycle Rental

Students wishing to rent a bicycle for the six weeks of the program may do so at the ASUCD Bike Barn. Cost for bike rental for 6 weeks is estimated to be $175. Students who choose to rent a bike will be escorted to the bike barn by our program staff on the first Monday of the program. Payment for bike rentals will be accepted on the first day of the program and is not included in the cost of the program.

Medical Insurance

Each participant’s family is responsible for providing medical insurance for the duration of the program. Please make sure that that insurance is valid for the duration of the program.

UCD- YSP Payment Information

2016

Payment Schedule

April 29, 2016 - $2200 Non-Refundable Deposit Due ($2175 + $25 Application Fee) Payment may be made by Cashier’s Check or online credit card payment June 1, 2016 - $4000 Total balance due

Payment may be made by cashier’s check or online credit card payment. You may make partial payments at any time between April 29th and June 1st if you choose.

Please use the payment coupons for each payment. Please include a copy of any online payment confirmations including the transaction number.

Address for mailed payments J. Richard Pomeroy

UC Davis –Young Scholars Program School of Education

University of California One Shields Avenue Davis, CA 95616-8579

UC Davis – Young Scholars Program

Online Payment Instructions

To make an online credit card payment, follow these instructions:

1. Log into your account on http://ysp.ucdavis.edu

2. You will see a payment block like the table below on the left side of the home page.

YSP Payments

Awards and reductions: $ 0.00 a. Fee reductions and Application fee waivers

Amount received from you: $ 25.

b. This box contains the amount you have paid

Non-refundable deposit: $ 0.00

Total balance: $ 0.00 d. This is the amount due by June 1

.

3. To pay the non-refundable deposit, click on the “Pay now via credit card” link at the bottom of

the block and follow the online payment instructions.

4. Complete the information on the secure payment site

5. Be sure to retain a copy of your payment confirmation for your records

6. Once the online credit card payment has been received, the “Total balance due” will change

from $4000 to what you still owe.

7.

After

paying the non-refundable deposit, you can pay your “balance due” in as many

payments and at any time in any amount you want as long as the balance is paid in full by the

close of business on June 1, 2016.

8. If you choose, you may pay the non-refundable deposit and balance due with cashier’s checks

or certified checks. If you choose this option, please mail the checks with the payment

coupons included in the Acceptance Package Forms.

9. A housing deposit of $200 in the form of a

personal check

made out to UCD-YSP must

accompany the mailed in acceptance form regardless of the method you choose for paying the

non-refundable deposit.

Mail all materials to

:

J. Richard Pomeroy

UC Davis Young Scholars Program

School of Education

One Shields Avenue

Davis, CA 95616-8579

Please separate and include ONE of the attached payment coupons with each payment. If paying by credit card, please include a copy of the transaction confirmation with the transaction reference number. Please complete all of the information on the form for each payment. All fields must be completed so that we can process your payment information. Upon receipt, these forms will be kept in our accounting office to protect your privacy.

Payment #1-Non Refundable Deposit DUE April 29, 2016 or within 2 weeks of acceptance. Student’s name: ___________________________________ Student User ID#: ________________________ Home Address: _____________________________________________________________________________ Home Phone: __________________ Work Phone: __________________ Cell Phone: ____________________ Parents’ email address: ______________________________________

Housing Security Deposit ($200 Personal Check ONLY): _______________ Non-Refundable Deposit ( $2200 No Personal Checks) Amount of payment: _______________ _____ Check here if non-refundable deposit paid at online credit card site.

Payment transaction number: _________________________________

Amount of payment: _______________

--- Cut Here ---

Payment #2

Student’s name: ___________________________________ Student User ID#: ________________________ Home Address: _____________________________________________________________________________ Home Phone: __________________ Work Phone: __________________ Cell Phone: ____________________ Parents’ email address: ______________________________________

Online payment transaction number: _________________________________

Amount of payment #2: _______________

--- Cut Here ---

Final Payment - DUE no later than 2 weeks before the start of the program.

Student’s name: ___________________________________ Student User ID#: ________________________ Home Address: _____________________________________________________________________________ Home Phone: __________________ Work Phone: __________________ Cell Phone: ____________________ Parents’ email address: ______________________________________

Online payment transaction number: _________________________________

UCD-YSP Authorization to Consent to

Treatment of a Minor

and Emergency Contact Information

I/We, the undersigned guardian(s) of

____________________________________________________________, a minor, do hereby authorize J. Richard Pomeroy or his Designee to act as an agent for the undersigned and to give informed consent to any medical treatment which is deemed advisable by licensed physicians practicing at Cowell Student Health Center or local medial facilities.

It is understood that this authorization is given in advance of any specific diagnosis or treatment being required, but is given to provide authority and power on the part of our aforesaid agent to give informed consent. It is our understanding that we will be contacted in the event of illness or injury if at all possible. This authorization shall remain effected between June 19 through July 30, 2016, unless sooner revoked. Guardian name (printed): ________________________ Relationship: ____________________________ Guardian signature: ____________________________ Date: _______________________________

Guardian contact information

Home phone: __________________ Address: _______________________________________

Business phone: ________________ City: ___________________ State: _________________ Mobile phone: _____________________ Zip Code: ____________________________

Emergency contact (if primary guardians cannot be reached)

Name (printed): ______________________ Relationship: _______________________________ Phone #1: __________________________ Phone #2: ________________________________

Insurance information

Is your child covered by medical insurance? _________ Yes _________ No If “YES”: Insurance Company:________________________________________________________________ Company or Group: _________________________________________________________________ Address:__________________________________________________________________________ Name of Insured:___________________________________________________________________ Policy/Group Number: ______________________________________________________________ Policy/Group Number: ______________________________________________________________ Special conditions for use of insurance:

UCD-YSP Medical History

To be completed by parent/guardian. Attach additional paper if necessary.

Scholar’s Name: ____________________________________________ DOB: ___________

Scholar contact information

Mobile phone: ________________________ Address: __________________________________________ Summer email: _______________________ City: ____________________ State: _________________

Zip Code: ____________________________

Physician information

Physician: ____________________________ Date of latest physical examination: _____________________ Physician address: _______________________________________________________________________ Physician phone number: _________________________________

Is your child presently under physician’s care? _________ Yes_________ No If yes, please describe below. May we contact the physician if necessary? _________ Yes _________No

Medical history

Does your child have medical problems or has he/she been seriously ill or hospitalized in the past three year? _________ Yes _________ No If yes, please describe below. Are there limits to your child’s physical activities?

_________ Yes _________ No If yes, please describe below. Is your child have any dietary restrictions, including vegetarian or vegan?

_________ Yes _________ No Describe specific dietary restrictions below? Date of last tetanus immunization: _____________

Can your child swim? _________ Yes _________ No Does your child wear contacts? _________ Yes _________ No Does your child carry an inhaler? _________ Yes _________ No Does your child carry in epi-pen? _________ Yes _________ No

Please describe any pertinent medical history, drug, food, or environmental allergies, previous illness/injury, activity or dietary limitations, etc. Attach additional pages if necessary.

_______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

UC Davis-Young Scholars Program

FERPA Rights

I understand that the Family Education Rights and Privacy Act of 1974 (FERPA), as

amended, affords students the right to authorize the release of education information to third

parties. I also understand that studying special programs /off campus may involve

circumstances which require UC Davis to release certain information to third parties, but for

which it may be difficult to obtain my prior written permission. For these reasons, I herewith

authorize university officials to release my education information to parties, who, in their

judgment have an interest in the special program/off campus contemplated by this document

provided that those officials, in their judgment, are acting in my interest as well. This

authorization is valid from the time I signed document to Summer Sessions Special Program

through a period of one quarter after my program ends.

UC Davis Young Scholars Progrma

Expectations

Updated 4/1/16- JRP

The Young Scholars Program is an intense six-week experience with many new and exciting opportunities. It is the goal of program staff to insure each student’s experience is the best possible. In order to insure this, participants must

understand that ground rules and expectations, established by the University, and program staff, are required. UCD-YSP participants agree to abide by these rules and expectations. Repeated or willful violation of the rules and expectations, open defiance, disrespect of staff or willful destruction of University property will result in removal from the program with a grade of Not Passed (NP).

• All work in the UCD-YSP is graded. Grades will be based on student participation, assignments, lecture exam,

research paper, research presentation, and final home school presentation. Grades will be issued upon completion of the home school presentation. Students failing to complete the home school presentation by December 31st will receive a grade of Not Passed. (NP).

• UCD-YSP participants are not allowed to ride with drivers other than their parents, guardians, UCD-YSP staff or, with

permission, their research team.*

• UCD-YSP participants are not allowed to have motor vehicles under any circumstances. • UCD-YSP participants are not allowed to use tobacco, alcohol, or other illegal drugs.* • UCD-YSP participants will have a curfew each night as follows:

o Sunday-Thursday -Participants are in the dorm by 10PM and in their rooms by 11PM.

o Friday-Saturday - Participants are in the dorm by 11PM and in their rooms by 12PM.

• When leaving the dorms for activities other than lab or organized program activities participants must sign out and

be accompanied by at least one other participant of the UCD-YSP. When leaving with staff, three people must be present.

• When males and females are in a room together, the door must remain fully open.

• Non UCD-YSP visitors, other than immediate family, are permitted in the first floor lounge and entry hall areas of the

dorm only. No over night visitors will be allowed.*

• Intimate relations are not allowed.*

• UCD-YSP participants are expected to be on time to all activities.

• UCD-YSP participants will adhere to all UCD-YSP, University of California, Davis, and University Conference

Housing rules and regulations.

• Research mentors have graciously agreed to host UCD-YSP participants in their labs for the duration of the

program. The participant agrees to work as a colleague with others in the lab recognizing that they are guests in the lab group.

Failure to comply with the rules indicated with an * will result in immediate dismissal from the program with no refund. Repeated violations of any rules or expectations may lead to dismissal from the program with no refund.

I have read and discussed these expectations with my parents and I agree to abide by the expectations as stated above.

X ___________________________ ___________ X _____________________________ _________ Participant signature Date Parent Signature Date

UC Davis Young Scholars Program

Acceptable Use Policy

Parent and Scholar,

As a participant in the UC Davis - Young Scholars Program, you will have access to a wide

variety of technologies and resources during your work on campus. The program dormitory

computer facility and your labs will have computers that are connected directly to the Internet. It

has been widely publicized that the Internet is an unregulated medium and as such may contain

material that would be deemed inappropriate for minors. It is unrealistic to believe that any

member of the UC Davis Young Scholars Program staff can directly monitor your use of the Internet

during the program. Therefore, it is your responsibility to use these resources solely for the

purposes of your research or personal communication. Downloading of material not directly

associated with your research is an inappropriate use of campus computers and is not allowed.

Should you happen upon a site that would be unacceptable for use in a public school you should

immediately exit that site. It is your responsibility to avoid or exit inappropriate sites. Should you

choose to visit inappropriate Internet sites or download non-research related materials during the

program, you will receive one warning to stop such activities. After that, continued visitation to

inappropriate sites or downloading of material not associated with your research will be grounds for

dismissal from the program with no refund. In order to verify your understanding of this policy,

please sign in the space below and return this document with your Confirmation Form and

Non-Refundable Deposit.

J. Richard Pomeroy

Director, UCD-YSP

I have read and understand the conditions for use of the Internet as described above.

UC Davis Young Scholars Program

Social Media Policy 2016

Update 4/3/16- JRP

Digital communications andsocial media, (text messages email, Facebook, Edmodo, Twitter, Instagram, Shutterfly etc.) have become a daily part of our lives. Instant communications can be a powerful way to reach a wide range of individuals quickly. It is also an area of concern in that once a message, image, or comment is posted, it develops a life of its own that can be very long lasting. In consideration of the power, both positive and negative, of digital communications and social media the UC Davis - Young Scholars Program has or will establish official channels for use by our staff and participants during and after the program. These portals currently exist (Facebook: Young Scholars Program at UC Davis) or they will be created and

announced at the start of the program. The rules and policies associated with digital communications and social media will remain in effect for staff and participants for one year after the conclusion of the program. Person to Person Communications

• All person-to-person digital communications (email and text etc.) initiated by staff will be cc’d or group

texted to include at least one additional member of the YSP staff for archival purposes. Social Media

• Staff postings to social media sites (Facebook, Twitter, Instagram etc.) will be to the official program

sites only. Program administration reserves the right to monitor and edit all postings in the best interest of participants, the program, and the University.

• Images posted to social media sites will be monitored by program staff to respect participants,

research, and privacy.

• UCD-YSP will maintain the official YSP website as the official source of program information. Postings

to other social media sites should be verified on the official YSP website (http://ysp.ucdavis.edu)

• Students posting images from the program on their own social media sites are asked to respect the

privacy and feelings of others in the pictures. UCD-YSP retains the right to monitor images where logos, or other identifiers of the program are visible in images, text, or sound and the right to request that images be removed if they reflect poorly on individuals, research or the program.

• No images from research placements may be posted without written permission of the Principle

Investigator.

I have read and understand the Social Media Policies described above and agree to abide by these policies for the duration of the program plus one year.

UC Davis Young Scholars Program

Photo Release Form

Authorization & Consent for Use of Name, Voice, and Likeness Dear Participant/Parent,

As one of the ongoing projects in YSP, we will be posting pictures to a website and/or Facebook on a regular basis. This website is intended for parents, family members, potential applicants, and the greater community to see a brief glimpse of the activities of the participants in UCD-YSP. We would like your permission to post you/your child’s pictures to our website/Facebook page as they participate in program activities. Photos will only be taken during public portions of the program such as the lecture series, lab work, field trips, and activities. Only students’ first names will be included with the web photos.

In addition, we will be sending a press release to each students’ hometown newspaper with a photo of that student doing their research, for which we need your permission. All newspaper photos will be taken by the program staff, the media consultant for the UCD School of Education, or a photographer from the participant’s hometown newspaper.

Participants may independently create a photo-sharing site. YSP staff and the School of Education have no control over individuals’ postings on non-sponsored sites.

If you grant your permission to use pictures of you/your son/daughter (if they are under 18 years of age) for these purposes, please read and sign the form below.

Thank you in advance for your cooperation, J. Richard Pomeory

Director, UCD-YSP

I hereby authorize and consent to the use of my/my child’s name, voice, photograph and likeness by The Regents of the University of California without reservation or imitation.

As used herein, “photographs” shall include any photograph, photographic reproduction or facsimile, still or moving, or any videotape or live transmission, or any recordings thereof.

The undersigned agrees to receive no compensation. Property rights to any photographs of the undersigned produced or prepared by The Regents of the University of California, or any agent thereof, pursuant to this authorization and consent, shall vest in and remain with The Regents of the University of California.

Said photographs of the undersigned may be used via print, the Web and any over-the-air and/or closed circuit broadcast transmission facility.

The undersigned by his/her signature below waives any cause of action for personal injury and/or property damage by virtue of the taking and use of photographs herein described by The Regents of the University of California.

This authorization and consent shall be binding upon the undersigned heirs, successors licensees, agents and assigns, and shall be governed by the laws of the State of California.

I give my permission to use ______________________________________________________________’s picture/likeness for the purposes described above. (Participant’s Name)

______________________________________________________________ __________ (Participant/Parent’s Signature) (Date)

Survey Consent Form

2016

The goals of the UCD-YSP are to acquaint participants with scientific research and university life through a six-week summer residential research program. As part of this program, participants will live in university dorms, attend formal and informal lectures and presentations, and conduct research as members of the university research community.

In order to monitor the effectiveness of the program in meeting its goals, participants and parents may be asked to respond to brief questionnaires or surveys before, during, and after the program. The surveys will be administered by program staff and will be used for the purposes of determining the efficacy of the program and ways to improve the program for future years.

No more than three surveys or questionnaires will be distributed. Responses to these surveys will be held in the strictest confidence and will not be used for any other purpose.

Prior to completing the first survey, all participants will be given the opportunity to pick a unique identification code. Participants will be asked to use that code on all subsequent questionnaires. For the purposes of confidentiality, a record of that unique identification code will be kept by a faculty member in the School of Education who is not associated with the program. The codes will only be revealed after final grading has been submitted and then only to allow for analysis of the survey results.

Survey results will not be identified by individual participants nor will they be used in any way for selection, project matching, or grading. All participants will remain anonymous in any and all reports prepared from the survey information.

• Participants have the right to not participate in the surveys if they so choose.

• Participants have the right to receive copies of any reports prepared from the information

gathered in the surveys when such reports have been completed.

Your signature in the spaces below indicates your voluntary willingness to complete the surveys and questionnaires described above.

Participant Date Parent Date

Thank you for agreeing to assist us in evaluating the program for the purposes of meeting studentsʼ

needs and providing the best program possible in future years. If you have any questions, please do not hesitate to contact the Director at (530) 752-0622 or via email at [email protected]

J. Richard Pomeroy Director, UCD-YSP

Participant’s Name (Print):

Participant’s Age (If Minor):

UNIVERSITY OF CALIFORNIA, DAVIS BODEGA MARINE RESERVE

Waiver of Liability, Assumption of Risk, and Indemnity Agreement

Waiver

: In consideration of being permitted to visit or participate in any way in any activity,

including transportation, at the above location, I, for myself, my heirs, personal

representatives or assigns,

do hereby release, waive, discharge, and covenant not to sue

The Regents of the University of California, its officers, employees, and agents from liability

from any and all claims including the negligence of The Regents of the University of

California, its officers, employees, and agents,

resulting in personal injury, accidents or

illnesses (including death), and property loss arising from, but not limited to, visitation or

participation in any way in any activity, including transportation, at the above location.

Signature of Minor’s Parent/Guardian Date

Signature of Participant

Date

Assumption of Risks:

Visitation or participation carries with it certain inherent risks that

cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary

from one activity to another, but the risks range from 1) minor injuries such as scratches,

bruises, and sprains to 2) major injuries such as eye injury or loss of sight, joint or back

injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and

death.

I have read the previous paragraphs and I know, understand, and appreciate

these and other risks that are inherent

in visitation or participation. I hereby

assert that

my visitation or participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless:

I also agree to INDEMNIFY AND HOLD The

Regents of the University of California HARMLESS from any and all claims, actions, suits,

procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a

result of my involvement in visitation or participation

and to reimburse them for any such

expenses incurred.

Severability:

The undersigned further expressly agrees that the foregoing waiver and

assumption of risks agreement is intended to be as broad and inclusive as is permitted by the

law of the State of California and that if any portion thereof is held invalid, it is agreed that

the balance shall, notwithstanding, continue in full legal force and effect.

Acknowledgment of Understanding:

I have read this waiver of liability, assumption of

risk, and indemnity agreement, fully understand its terms, and

understand that I am giving

up substantial rights, including my right to sue

. I acknowledge that I am signing the

agreement freely and voluntarily, and

intend by my signature to be a complete and

unconditional release of all liability

to the greatest extent allowed by law.

Section 290-32

Exhibit B

8/25/08

Project Checklist for Minors Performing Research in Laboratories

Minor’s Name: _____________________________________________________________

Date of Birth: ______________________________________________________________

Supervisor: __________________

J. Richard Pomeroy or his designee

__________________

Principal Investigator ___________

To Be Assigned

_________________________________

Time Frame of Research Project:

June 19- July 30, 2016

__________________________

_ X

_ Check here if this minor will be participating in a research laboratory project

___ Check here if this minor will be participating in a classroom or educational outreach program.

Project Summary and types of experiments to be performed:

Students may be engaged in laboratory research and or field work, creating, collecting, and or processing samples, on a daily basis. Under the direct supervision of research faculty and or laboratory personnel, projects may involve computer modeling, molecular biology, chemistry, ecology, engineering and or environmental systems. All students will

participate in both online safety training prior to the start of the program and in person laboratory safety and procedures orientation as part of the program orientation. Any additional required training will be provided based on the exact nature of the research project.

Minor’s prior research experience: (

Approved exceptions to guidelines (requires approval of appropriate Committee/s)

Any required approvals will be obtained before the start of work.

Signatures (must be completed prior to beginning work):

Minor: __________________________ Parent or Guardian: ____________________________

PI: ___

_____________________________________________

Supervisor

____________________________

EH&S Officer(s) below:

CHO __________________________________________________________________________

BSO __________________________________________________________________________

RSO __________________________________________________________________________

1 |

P a g e

SISS, UC Davis, University House, One Shields Avenue, Davis, CA 95616 ● 530-752-0864 ● siss.ucdavis.edu

Frequently Asked Questions (FAQs)

from

International Students about the

Young Scholar Program (YSP)

Thank you for your interest in the Young Scholar Program (YSP) at UC Davis. International students who

participate in the program have additional requirements required to enter and stay in the United States

while they participate in the program. The following Frequently Asked Questions (FAQs) may help you

decide whether or not to participate.

Q: What if I am an international student who is already studying inside the U.S.?

A: If you are already in the United States, please contact Services for International Students and Scholars

at

[email protected]

for more information on how to participate in the YSP.

Q: What timeline should international students expect once accepted to the YSP?

A: Because the time required for obtaining a U.S. visa varies based on the availability of visa

appointments and because some visas require additional time to process, it is very important to get an I-20

as soon as possible. To allow adequate time, international students wishing to participate in the program

should:

• By April 15th: Accept their offer of admission and pay the required deposit.

• By April 20th: Once assigned a University ID, request an I-20 by submitting a copy of the passport and

funding required (instructions will be emailed to you).

• Mid-May: Once the I-20 is received, the student and parent must sign the I-20 acknowledging that they

will follow all F-1 student regulations, pay the SEVIS I-901 fee and make a visa appointment. We

recommend checking the current wait time for obtaining a visa as well as prepare for your visa interview.

• Enter U.S. with F-1 visa May 20th-June 18th: Wait to make travel arrangements until the visa has been

issued OR make sure the travel plans can be adjusted if the visa takes longer than expected.

Q: What items can be prepared while waiting to be accepted to the YSP?

A: Minimum requirements for an I-20:

• The student should have a passport that is not expiring until at least 2017.

• A recent bank statement no older than 3 months old showing the amount of at least the program expense

of $6,200 plus the cost of any health insurance purchased for the duration of the program.

• If the funds are not in the student’s bank account, prepare a letter from the owner of the bank account

stating that they will sponsor the cost of the YSP for the student.

Q: Do international students have any additional costs to participation in the YSP?

A: Yes. There is a

$159 UC Davis fee

, a

SEVIS I-901 fee

, a

visa fee

, and any additional costs associated

with maintaining the required health insurance.

Q: What are the health insurance requirements for international students participating in the YSP?

A: International students are required to have health insurance that covers at minimum:

• Medical benefits per accident or illness of at least: $100,000 minimum

• Repatriation of Remains: $25,000

• Expenses related to Medical Evacuation: $50,000

• Deductible per accident or illness not to exceed $500

• Contact Emily Taylor at [email protected] for a recommendation about an insurance provider if

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SISS, UC Davis, University House, One Shields Avenue, Davis, CA 95616 ● 530-752-0864 ● siss.ucdavis.edu

Q: What should you expect during your visa interview?

A: You will be expected to bring documentation and answer questions during your interview:

• Bring your passport, I-20 signed by the student and the parent, original bank statement(s), sponsor letter(s)

if applicable, your acceptance notification into the Young Scholar program, and anything else you were asked to bring when filling out the I-160 appointment request.

• Be prepared to answer questions about why you want to participate in the Young Scholar program at UC

Davis and how you are prepared for the program.

• Be prepared to answer questions about how you will finance this program (show financial documents).

• Be prepared to talk about what you will do after the program is finished and what will bring you back to your

home country when you are finished. Most students talk about returning to school, family, investments (money in a bank account), or property (your home) to show strong ties to your home country.

Q: How early can an international student enter the U.S. to participate in the YSP?

A: If the visa is issued in a timely manner, students can enter the U.S. up to 30 days prior to the program,

but they are not eligible to check in to the program before the program start date.

Q: Can parents accompany their international students to the U.S.?

A: Yes, parents are welcome to accompany their students to the U.S. but will need their own visas. There

are no provisions for parent participation or housing in the program other than dinner on the opening night.

Q: How can parents obtain a visitor visa?

A: Visitors who are not eligible for a

visa waiver

must apply for a

B-2 visa

.

Q: Are there any additional requirements for international students once they arrive at UC Davis?

A: Yes. International students must:

• Attend an orientation arranged by the YSP

• Activate their SEVIS record by completing an online check-in discussed during the mandatory orientation

• Maintain the required health insurance for the duration of the YSP

• Maintain their SEVIS status by fully participating in the YSP

Q: Can an international student stay in the U.S. following the completion of the YSP?

A: Yes, students who complete the program must check out of the program on July 30

, but are not

required to leave the U.S. until the end of their 60 day grace period.

Q: What if I have additional questions about international student requirements?

A: Email your questions to

[email protected]

. Identify yourself as an applicant to the Young Scholar