Field Camp Application
Application Deadline: Feb 14th 2025
Name:
*
First Name
Last Name
Email Address:
*
Confirmation Email
For approval, ensure email is correct
Date of Birth:
*
-
Month
-
Day
Year
DOB
Gender:
*
Female
Male
Non-Binary
Other
University/College of Current Enrollment:
*
University you are currently attending.
Expected Graduation Date:
*
-
Month
-
Day
Year
PeopleSoft ID:
Provide this IF you are a student at University of Houston.
Status (as of Spring 2022):
*
Freshman
Sophomore
Junior
Senior
Graduate
Major:
*
Cumulative GPA:
*
Your Permanent Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
Idaho
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Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Montana
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New Hampshire
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New York
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Ohio
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Oregon
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South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Your Phone Number
*
-
Area Code
Phone Number
Emergency Contact Name:
*
Emergency Contact Number:
*
-
Area Code
Phone Number
Plan of field camp enrollment:
*
Geology Session 1 (6/2 – 7/6/2025)
Geophysics (Not available in 2025, do not select; see GEOL 4397 ST99)
Planned credit hours of Geology Field Camp?
*
6 Credit Hours
3 Credit Hours
Geology Prerequisites
*
Pass
Fail
Not Taken
In Progress
GEOL 3345 (Structural Geology)
GEOL 3145 (Structural Geology Lab)
GEOL 3350 (Principles of Stratigraphy)
GEOL 3150 (Principles of Stratigraphy Lab)
Geophysics Prerequisites
*
Pass
Fail
Not Taken
In Progress
GEOL 4330 (Introduction To Geophysics)
Faculty or academic advisor who can verify your academic information:
Name :
*
Email:
*
Attach your Transcript:
*
Click to select file
Name it Lastname_Firstname.pdf
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Do you have a physical or medical condition that might limit your ability to participate in the often strenuous physical activities of a field camp? If your answer is “yes”, you must obtain and submit written permission from your doctor allowing your participation in our field camp program.
*
YES
NO
Written permission from doctor allowing participation in the field camp
*
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Geology Field Camp: I acknowledge that I can hike up to 5 miles with an elevation gain of up to 1,000 ft in hot weather.
*
YES
NO
Geophysics Field Camp: I acknowledge that I can work full days outdoors in summer conditions in the Galveston vicinity.
*
YES
NO
Proof of Medical Release from doctor allowing participation in the camp
*
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Student attending field camp are required to carry health insurance for the duration of field camp. Please provide the name of your insurance provider (If you don't have insurance and plan to get it by the start of camp, please indicate below) :
*
Add Medical Insurance Provider Name
If you have a scanned copy of your medical insurance, please attach:
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By entering my name below, I certify that all entries on this application are complete and accurate to the best of my knowledge.
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