Course Abroad - Program Fee Form Note: Payment must be made via credit card. Payments are non-refundable and hold your seat in the course. < All fields marked with an * are required. First Name Last Name N# University Name or Affiliation School Name Email Phone Address City State New York Non-US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Postal Code Country United States Afghanistan Albania Algeria American Samoa (US) Andorra Angola Anguilla (UK) Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda (UK) Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands (UK) Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands (UK) Central African Republic Chad Chile China Christmas Island (AU) Cocos (Keeling) Islands (AU) Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands (NZ) Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (UK) Faroe Islands (DK) Fiji Finland France French Guiana (FR) French Polynesia (FR) Gabon Gambia Georgia Germany Ghana Gibraltar (UK) Greece Greenland (DK) Grenada Guadeloupe (FR) Guam (US) Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See (Vatican City) Honduras Hong Kong (CN) Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakstan Kenya Kiribati Korea, Democratic People's Republic (North) Korea, Republic of (South) Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau (CN) Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall islands Martinique (FR) Mauritania Mauritius Mayotte (FR) Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat (UK) Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles (NL) New Caledonia (FR) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island (AU) Northern Mariana Islands (US) Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands (UK) Poland Portugal Puerto Rico (US) Qatar Reunion (FR) Romania Russia Rwanda Saint Helena (UK) Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon (FR) Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & South Sandwich Islands (UK) Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands (UK) Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands (US) Wallis and Futuna (FR) Western Sahara Yemen Zambia Zimbabwe PADM-GP 2249: Scaling Social Enterprises San Salvador, El Salvador Sunday, January 8 (arrival day) - Friday, January 20 (departure day) The program fee will cover: Pre-departure preparation session and materials Opening and closing dinner Transportation including airport arrival/departure and travel to site visits Housing in El Tunco, San Salvador, and Chalatenango City tour and day trip Lecture sites and guest speakers There are two options for payment for the El Salvador program fee. Pay full amount of $1800 (due by October 10) Pay 50% of program fee ($900) by October 10 and 50% ($900) on December 1, 2022* *Enrollment in the course is dependent on payment of the deposit. If the second half of the deposit is not submitted by December 1, 2022, you will be dropped from the course and not receive a refund. Please choose one option: Option 1: Pay full amount $1800 Program Fee Deposit: $1800 Option 2: Pay 50% ($900) now, 50% on December 1, 2022 Program Fee Deposit: $900 Please check at least one box above to indicate program(s) you are attending. Confirm Total Payment:$ Notice: New York University is committed to respecting your privacy. You can be assured that personal information will only be used by New York University to conduct official University business and personal information will never be disseminated to any unaffiliated third party. Please refer to the New York University's privacy policy for more information.