Costa Rica Registration Form

Reserve your spot for the Costa Rica Trip!

Completing this form allows you to reserve your spot for the trip, make your $500 non-refundable deposit, and you will be automatically enrolled in the course when registration opens.
Student Name*

First NameMiddle NameLast Name
Mid Michigan College Student ID Number*
You can find your Student ID Number on your Mid Michigan College Student ID Card or in your Self-Service Account.
Birth Date*

MonthDayYear
Mid Mich Email*
example@midmich.edu
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has your information changed from your admission or previous registration?*

YesNo
Discuss your motivation for registering for the study abroad to Costa Rica.*
Describe your previous travel experience (in or out of school).*
This trip includes living at a research station with limited electricity, limited cell service/wifi access, no access to stores, etc. Discuss how you will prepare for and embrace this unique experience.*
List the names and contact information for two personal references, with one being a Mid Michigan College employee (if possible). *
Confirm your selection and complete payment via PayPal using the options below.*
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2025 Costa Rica Trip DepositThis deposit is non-refundable.
$500.00

Total

$0.00
Student Signature*

Clear
Date*

MonthDayYear
NOTE Registration is not complete until this form is submitted. If submitted, it obligates you, the student, to pay a registration fee of $50 (if initially registered during the regular enrollment period) or $100 (if initially registered during the late enrollment period). This fee is refundable if all courses are dropped prior to the final tuition deadline for the term. This fee will be covered by financial aid if your aid has been approved and is in your account. You will be responsible for all tuition and fees for courses dropped after the first Friday of the semester.
Pay with PayPal

Choose from one of the PayPal options to make your payment.
Should be Empty:

Reserve your spot for the Costa Rica Trip!