Study Abroad Programs 2006-2007

Sheffield Hallam

__________________________, 200 ____

We _____________________________, _______________________ parents of  

____________________________________ give our/my son/daughter permission to

participate in the Study Abroad Program at Sheffield Hallam in the Fall/Spring/Summer ______. We/I agree with the information provided by Dr. Mainuddin Afza for the Study Abroad Program/s. I relieve Dr. Mainuddin Afza, CoB, and Bloomsburg University of Pennsylvania  any liability with regard to bodily or mental harm which may occur

during the Study Abroad Program under her coordination. I certify that I read the enclosed program description and understand its terms and stipulations.

__________________________

Parent/s or Guardian Signature

__________________________

Student’s Signature

Please sign the release form and have it notarized and return as soon as possible to Dr. Mainuddin Afza, CoB, Bloomsubrg University, 208 Sutliff Hall, 400 East Second Street, Bloomsburg, PA 17815-1301.