Costa Rica Co-op Study Tour 2025 - Registration Form



Thank you for registering for this international co-operative tour and learning experience. We collect the following for planning and in-country purposes. Your will information will not be shared with anyone outside the program.

* First and Last Name (and pronouns if you wish)
0/50
* Name of your organization (Credit Union, Co-operative or other)
0/250
* Relevant Job or Role Title(s)
0/50
* Email Address for Program Correspondence
0/50
* Mailing Address: Street, Town, ZIP/Postal Code
0/250
* Country
0/50
* Cell Phone #, including country code (for use during the program)
0/50
* WhatsApp # for group communication use during the tour (or please note if you don't have an account yet)
0/50
* Emergency Contact: name, relationship to you, phone number (including international code), email address
0/250
* I take responsibility for my trip preparation including (ALL boxes must be checked):
 
* Photographs will be taken during the tour and some will be used for International Centre for Co-operative Management communication purposes. These will be photos of tour activities (e.g. opening dinner, group shots, co-op visits). Do you authorize the use of photographs that include you?
0/250
Please provide a Biography / Profile
0/500
* Do you have any allergies (food or otherwise) or health-related intolerances (food)?
0/250
* If you answered YES or OTHER to the previous question, specify your allergies here (e.g. shellfish, dairy, gluten, bee sting) and indicate severity clearly (e.g. intolerant, severe reaction, anaphylactic, etc.). If you answered NO above, simply type in not applicable below.
0/250
* Do you have any dietary restrictions that are not allergies or health related intolerances? If YES, be specific (e.g. no pork; vegan; vegetarian but eats fish; etc.). If you have no restrictions, state NO as your response.
0/250
* Describe any accessibility challenges (e.g. climbing stairs or walking or other). Some of the program activities may be in buildings or locations that aren't accessible by wheelchair, may require climbing flights of stairs, standing, and walking. Some locations may not be able to accommodate all mobility restrictions.
0/250
* Do you have any health concerns that we should be aware of? If yes, please provide basic information and indicate whether any accommodations are required during the program (e.g. fridge required for medication).
0/250
Do you have any questions or concerns? If so, specify those here and someone will get back to you by email. ** If you are requesting to share a room with another tour participant, please indicate that here.**
0/250
* Do we have your permission to share basic contract information (your name, title, co-op, email, phone #) with other tour participants and leaders at the end of the tour?
 

Thank you for your registration. An invoice will follow via email.



Please contact Jillian Stagg, ICCM Education Coordinator ([email protected]) with any questions.
Submit Registration
If you just opted in, you're consenting to receive marketing emails from: Saint Mary's University, Sobey Building 330, Saint Mary's University, 923 Robie Street, Halifax,, NS B3H 3C3. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact