{"id":18,"date":"2013-01-22T22:37:11","date_gmt":"2013-01-22T22:37:11","guid":{"rendered":"http:\/\/pages.palomar.edu\/dashburn\/?page_id=18"},"modified":"2019-03-01T18:20:21","modified_gmt":"2019-03-01T18:20:21","slug":"syllabus-history-108","status":"publish","type":"page","link":"https:\/\/pages.palomar.edu\/dashburn\/syllabus-history-108\/","title":{"rendered":"SAMPLE SYLLABUS History 108"},"content":{"rendered":"

Palomar COMMUNITY COLLEGE <\/b><\/span><\/span><\/span><\/p>\n

SAMPLE SYLLABUS History 108 (subject to minor changes)<\/b><\/span><\/span><\/span><\/p>\n

Daniella Ashburn <\/span><\/span><\/span><\/p>\n

ALL SECURE<\/b><\/span> Student\/Teacher correspondence<\/u><\/i><\/span> during the semester will happen via <\/span><\/span><\/span><\/p>\n

the internal CANVAS<\/u><\/span><\/span> ‘INBOX’ <\/u><\/span><\/span><\/b><\/i><\/span><\/span><\/span><\/p>\n

OFFICE HOURS BY APPOINTMENT<\/b><\/u><\/i><\/span><\/span><\/span><\/p>\n

SUBJECT AREA AND COURSE NUMBER:<\/b><\/span><\/span><\/span> History 108 <\/b><\/span><\/span><\/span>COURSE TITLE:<\/b><\/span><\/span><\/span> World History since 1650 <\/span><\/span><\/span>UNITS:<\/b><\/span><\/span><\/span> 3.00 <\/span><\/span><\/span><\/p>\n

Grade Only<\/span><\/span><\/span><\/p>\n

COURSE DESCRIPTION:<\/b><\/span><\/span><\/span><\/p>\n

This course examines the comparative history of the world’s civilizations in Europe ,Africa, and Asia, from the dawn the early modern era (1650) until the present. Topics in social, intellectual, economic, and political history are covered. This course is of interest to those planning to pursue a history major in the future as well as anyone seeking a global historical perspective. <\/span><\/span><\/span>The objective of this course is neither to be comprehensive nor definitive but to introduce the student to key themes, events and personalities of the period and to develop their critical thinking , writing , reading and note-taking skills. <\/span><\/span><\/span>This course is of interest to those planning to pursue a history major in the future as well as anyone seeking a global historical perspective. <\/span><\/span><\/span><\/p>\n

PREREQUISITES:<\/b><\/span><\/span><\/span> NONE<\/span><\/span><\/span><\/p>\n

LECTURE HOURS PER WEEK:<\/b><\/span><\/span><\/span> 3.00 <\/span><\/span><\/span><\/p>\n

STUDENT LEARNING OUTCOMES:<\/b><\/span><\/span><\/span><\/p>\n

U<\/span><\/span><\/span>pon successful completion of the course the student should be reasonably familiar with:<\/span><\/span><\/span><\/p>\n

    \n
  1. \n

    Historical causation from a wide, comparative perspective.<\/span><\/span><\/span><\/p>\n<\/li>\n

  2. \n

    The most significant cultural, political and social structures, forms of cultural expression in art and religion in discrete segments of the world’s civilizations.<\/span><\/span><\/span><\/p>\n<\/li>\n

  3. \n

    Key periods of world history and patterns of change from the early modern period to the present.<\/span><\/span><\/span><\/p>\n<\/li>\n

  4. \n

    The relevance and importance of developments of civilization in the modern era.<\/span><\/span><\/span><\/p>\n<\/li>\n

  5. \n

    The historical frame of reference from the early modern era to the post Cold-War era.<\/span><\/span><\/span><\/p>\n<\/li>\n<\/ol>\n

    METHODS OF INSTRUCTION:<\/b><\/span><\/span><\/span><\/p>\n

    Methods of instruction may include, but are not limited to, the following: <\/span><\/span><\/span><\/p>\n

    * Lecture <\/span><\/span><\/span><\/p>\n

    * 1. In-class discussion and small group work and discussion that permits students to share their ideas and critique both primary and secondary sources. <\/span><\/span><\/span><\/p>\n

    * 2. Use of film and other audio-visual media and maps to illustrate the historical events being presented. <\/span><\/span><\/span><\/p>\n

    * 3. Use of the Internet and\/or other computer-based technologies in doing historical <\/span><\/span><\/span><\/p>\n

    research <\/span><\/span><\/span><\/p>\n

    House Keeping Rules<\/b><\/span><\/span><\/span><\/p>\n

    – No Cell Phones, MP3 Players, laptops or any other electronic devices without prior permission .<\/span><\/span><\/span><\/span><\/p>\n

    – No food other than small snacks, or drinks in secure cups and or bottles. <\/span><\/span><\/span><\/p>\n

    – No book bags or other items on the desk other than those absolutely essential to the class. <\/span><\/span><\/span><\/p>\n

    – I will try to respond to your emails within 48 hours. <\/span><\/span><\/span><\/p>\n

    – Be a responsible student and do not assume I will follow up on missed lectures, exams and or assignments. What I do not know might hurt you. <\/span><\/span><\/span>If you have a problem , talk to me<\/i><\/span><\/span><\/span>! <\/span><\/span><\/span><\/p>\n

    REQUIRED READINGS<\/b><\/span><\/span><\/span>: <\/span><\/span><\/span><\/p>\n

    TEXT<\/b><\/span><\/span><\/span>: Ways of the World (with Sources) (V2) <\/span><\/span><\/span><\/p>\n

    by Robert Strayer<\/span><\/span><\/span><\/p>\n

    Publisher: Bedford Saint Martin’s : 1<\/span><\/span>st Edition (2011)<\/span><\/span><\/span><\/p>\n

    ISBN:9780312489182 <\/span><\/span><\/span><\/p>\n

    E-Book <\/b><\/span><\/span><\/span>available at<\/b><\/span><\/span><\/span> http:\/\/bcs.bedfordstmartins.com\/strayerdocutext1e\/#t_625564____<\/span><\/span><\/span><\/p>\n

    NOVELS<\/b><\/span><\/span><\/span> : 1. Bitter Bonds: A Colonial Divorce Drama of the 17<\/span><\/span><\/span>th<\/span><\/span><\/sup><\/span> Century (Paperback) <\/span><\/span><\/span><\/p>\n

    by Leonard Blusse <\/span><\/span><\/span><\/p>\n

    Publisher: M. Wiener Pub.; 1st Markus edition (July 2002) <\/span><\/span><\/span><\/p>\n

    ISBN: 1558762531 <\/span><\/span><\/span><\/p>\n

    Choose <\/i><\/span><\/span><\/span>One<\/b><\/i><\/span><\/span><\/span> of the following two titles:<\/i><\/span><\/span><\/span><\/p>\n

    2. A Long Way Gone by: Ishmael Beah<\/span><\/span><\/span><\/p>\n

    Publisher:Farrar, Straus & Giroux; 1st edition (2007).<\/span><\/span><\/span><\/p>\n

    ISBN:9780374105235<\/span><\/span><\/span><\/p>\n

    OR<\/b><\/span><\/span><\/span><\/p>\n

    3.A Woman in Berlin by: Anonymous<\/span><\/span><\/span><\/p>\n

    Publisher:St. Martin’s Press; (2005)<\/span><\/span><\/span><\/p>\n

    ISBN:9780312426118<\/span><\/span><\/span><\/p>\n

    Grading and Evaluation:<\/b><\/u><\/span><\/span><\/span><\/p>\n

    All graded assignments and exams must be completed to earn a passing grade. MAXIMUM POINTS AVAILABLE 100<\/span><\/b><\/u><\/span><\/span><\/span><\/p>\n\n\n\n<\/colgroup>\n\n\n\n\n\n\n\n\n\n
    \n

    EXAMS ( 1, 2 AND FINAL)<\/span><\/span><\/p>\n<\/td>\n

    		\n

    200<\/b><\/span> POINTS EACH<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    ATTENDANCE<\/span><\/span><\/p>\n<\/td>\n

    		\n

    75<\/b><\/span> POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    DISCUSSIONS<\/span><\/span><\/p>\n<\/td>\n

    		\n

    75<\/b><\/span> POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    GUIDED READING ASSIGNMENT<\/span><\/span><\/p>\n<\/td>\n

    		\n

    50<\/b><\/span> POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    INDEPENDENT ANALYTICAL PAPER <\/span><\/span><\/p>\n<\/td>\n

    		\n

    80<\/b><\/span> POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    HISTORY PRESENTATION <\/span><\/span><\/p>\n<\/td>\n

    		\n

    75<\/b><\/span> POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    VIDEO QUIZZES (2)<\/span><\/span><\/p>\n<\/td>\n

    		\n

    30 <\/b><\/span>POINTS<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    ON-TIME RESPONSES<\/span><\/span><\/p>\n<\/td>\n

    		\n

    15 <\/b><\/span>POINTS FOR FULL SET<\/span><\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Assignments:<\/b><\/u><\/span><\/span><\/span><\/p>\n

    Paper\/novel Discussions and Primary Source Discussions<\/b><\/span><\/span><\/span><\/p>\n

    There will be <\/span><\/span><\/span>two(2)<\/b><\/span><\/span><\/span> 4-5 page<\/b><\/span><\/span><\/span> papers<\/b><\/span><\/span><\/span> due in this class. These will be analytical essays primarily based on the novels. It is very important that students begin reading and thinking about their choice of books <\/span><\/span><\/span> well in advance <\/i><\/span><\/span><\/span> of the day of <\/span><\/span><\/span>discussion<\/b><\/span><\/span><\/span>( see schedule below). A reading guide for each book containing 10-15 questions is available on the course CANVAS site. Each student shall be given a personal assignment folder in which to answer all discussion questions. Answer the questions in a couple sentences for each and make sure to note the page numbers on which to find the answers. Be ready to make additional notes while we discuss the reading in class. The reading guide and discussions will help you prepare for your papers as well as the exams. Assignment folders will be collected after each discussion session.<\/span><\/span><\/span><\/p>\n

    The first paper will be on <\/span><\/span><\/span>Bitter Bonds<\/u><\/i><\/span><\/span><\/span> <\/i>(50 points ). <\/span><\/span><\/span>PDF @ MIDNIGHT ON CANVAS ON DUE DATE<\/b><\/span><\/span><\/span><\/p>\n

    The second paper will be on your choice of either : <\/span><\/span><\/span> <\/i><\/p>\n

    A Woman in Berlin <\/u><\/i><\/span><\/span><\/span>(80 points)<\/span><\/span><\/span>\u00a0<\/span><\/span><\/span>\u00a0PDF @ MIDNIGHT ON CANVAS ON DUE DATE<\/b><\/span><\/span><\/span><\/p>\n

    OR<\/b><\/span><\/span><\/span><\/p>\n

    A Long Way Gone<\/u><\/i><\/span><\/span><\/span> (80 points) <\/span><\/span><\/span>\u00a0PDF @ MIDNIGHT ON <\/b>CANVAS<\/b><\/span> ON DUE DATE<\/b><\/span><\/span><\/span><\/p>\n

    The essay topics will be available on the course site approximately two weeks prior to the due date.\u00a0<\/span><\/span><\/span><\/p>\n

    Primary Source Discussions<\/b><\/span><\/span><\/span> will consist of analyzing selected primary source documents that accompany the textbook chapters. Students will be divided into groups and will be assigned one or two of the primary sources that accompany the chapters under discussion that week. Using your assignment folder you are advised to answer the questions briefly, for yourself, in order to be able to fully participate in your group prep and the class discussions- <\/span><\/span><\/span>one person of each group should summaries the PS document<\/b><\/span><\/span><\/span>. Assignment folders will be collected after each discussion session.<\/span><\/span><\/span><\/p>\n

    History Presentations<\/b> will be 10-12 minute Power Point presentations on any topic , event or movement the student chooses. Please refer to the History Project Folder on the course CANVAS site for more information.<\/span><\/span><\/span><\/p>\n

    EXAMS<\/span><\/span><\/span><\/strong><\/p>\n

    All exams will cover lectures and reading assignments. Each exam will have two parts. Part I will be <\/span><\/span><\/span> On-line Multiple Choice Questions VIA CANVAS <\/u><\/i><\/span><\/span><\/span>and Part II will be SHORT ANSWER QUESTIONS\/IDENTIFICATIONS ANS 1 or 2 <\/span><\/span><\/span>Essay Questions<\/u><\/i><\/span><\/span><\/span> based on both the lectures, the textbook and the primary source readings. The study guide will be made available ONE week before the test. Your exams will be taken in your personal notebook which shall be handed to you at the beginning of each exam.<\/span><\/span><\/span><\/p>\n

    There will be NO MAKE-UPS<\/span><\/b> except for students with permission and or valid excuses. It is the responsibility of the student to follow up on any missed exam and or assignment.<\/span><\/span><\/span><\/p>\n

    Attendance and Late Papers:<\/b><\/span><\/span><\/span><\/p>\n

    Attendance will be taken throughout the semester, in the lectures and discussion sections. Any absences must be followed up by an email within 24 hours to be excused <\/u><\/i><\/span><\/b>. Poor attendance will affect your grade. Rosters will be cleared of NO SHOWS on the census date . FW final grades will only be assigned if requested. It is the student’s responsibility to drop classes they no longer attend.<\/span><\/span><\/span><\/p>\n

    Papers that are submitted late will only receive half credit.<\/b> <\/i><\/span><\/span><\/span><\/p>\n

    Alternate arrangements concerning exams or assignments are an option only for those students contacting me prior to test\/due dates. The day of the final exam is the last day that any late materials will be accepted\u2013 IF<\/span><\/b> arrangements were made prior.<\/span><\/span><\/span><\/p>\n

    ————————————————————————————–<\/b><\/span><\/span><\/span><\/p>\n

    COURSE OUTLINE AND SCOPE:<\/b><\/span><\/span><\/span><\/p>\n

    OUTLINE OF TOPICS and ASSOCIATED READINGS:<\/span><\/span><\/span><\/p>\n

    The following topics are included in the framework of the course but are not intended as limits on content. The order of presentation and relative emphasis will vary based on the progress we make week to week. <\/span><\/span><\/span><\/p>\n

    TB = Strayer Textbook Reading . <\/b><\/span><\/span><\/span><\/p>\n

    CANVAS Reading CR — Check for most up to date WEEKLY ASSIGNMENTS as semester goes by.<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Week 1 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Wednesday: –> CR Disclaimer Sources used. <\/b><\/span><\/span><\/span><\/p>\n

    Syllabus \u2192 print out and bring to class<\/b><\/span><\/span><\/span><\/p>\n

    Week 2 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB<\/b>:The Big Picture : Debating the character of an Era<\/u><\/i> <\/u>, ch 14 Empires and Encounters 1450-1750<\/u><\/i> <\/span><\/span><\/span><\/p>\n

    Reading Wednesday TB: <\/b>ch 15 Global Commerce 1450-1750 <\/u><\/i>. CR:<\/b> Working with Primary Sources.<\/span><\/span><\/span><\/p>\n

    Week 3 <\/b><\/span><\/span><\/span><\/p>\n

    Monday<\/b><\/span>: Absolutism <\/span><\/span><\/span><\/p>\n

    Wednesday: <\/b><\/span>Constitutionalism<\/span><\/span><\/span><\/p>\n

    Week 4 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b>ch 16 Religion and Science 1450-1750<\/u><\/i> <\/span><\/span><\/span><\/p>\n

    Wednesday in class Discussion<\/b> : Bitter Bonds ;A Colonial Divorce drama of the 17<\/u><\/i>th<\/u><\/i><\/sup> century<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Week 5 <\/b><\/span><\/span><\/span><\/p>\n

    EXAM 1 in class 2 essays <\/span>—> Please refer to the EXAM study folder CANVAS<\/span><\/b><\/span><\/span><\/span><\/p>\n

    ONLINE MC <\/span>Part 1 of the EXAM\u00a0<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Week 6 Bitter Bonds Paper PDF via CANVAS<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b>The Big Picture: European Centrality and the Problem of Eurocentrism, <\/u><\/i><\/span><\/span><\/span><\/p>\n

    Ch 17 <\/u>Atlantic Revolutions and Their Echoes<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion:<\/b> Selected Primary Sources ch 17 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    Week 7 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB<\/b>: ch 18 Revolutions of Industrialization 1750-1914<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion: Selected<\/b> Primary Sources ch 18 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    Week 8 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b>ch 19 <\/b>Internal Troubles External Threats: China the Ottoman Empire and Japan 1800-1914<\/u><\/i>. <\/b><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion<\/b> Selected Primary Sources ch 19 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    week 9 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b><\/span>ch 20<\/span> <\/b><\/i>Colonial<\/u><\/i><\/span> <\/b><\/u><\/i>Encounters 1750-1914<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion<\/b>: Selected Primary Sources ch 20 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    Week 10 S<\/span><\/span>pring <\/span>B<\/span><\/span>reak<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Week 11 <\/b><\/span><\/span><\/span><\/p>\n

    Monday: Movie and in class quiz<\/b><\/span><\/span><\/span><\/p>\n

    Wednesday EXAM<\/span> 2 in class essays <\/span>—> Please refer to the EXAM study folder CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    ONLINE MC<\/span> Part 1 of the EXAM on CANVAS<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Week 12 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b>The Big Picture:The Twentieth Century: A New Period in World History? <\/u><\/i><\/span><\/span><\/span><\/p>\n

    Ch 21 <\/b>The collapse and recovery of Europe 1914-1970s<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class Discussion :<\/b> A Woman in Berlin <\/u><\/i><\/span><\/span><\/span><\/p>\n

    Week 13 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b>ch 22 The rise and Fall of World Communism 1917-Present<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion <\/b>: Selected Primary Sources ch 22 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    Week 14 A Woman in Berlin Paper PDF @ Midnight via CANVAS<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b> ch 23 Independence and development in the Global South1914-Present<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion: <\/b>A long Way Gone<\/u><\/i> <\/span><\/span><\/span><\/p>\n

    Week 15 <\/b><\/span><\/span><\/span><\/p>\n

    Reading Monday TB: <\/b> ch 24 Accelerating Global Interaction since 1945<\/u><\/i><\/span><\/span><\/span><\/p>\n

    Wednesday in class discussion <\/b>: Selected Primary Sources ch 23 and 24 See Weekly Assignments CANVAS<\/b><\/span><\/span><\/span><\/p>\n

    Week 16 A long Way Gone Paper<\/span>. PDF @ Midnight via CANVAS<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Monday Movie (TBA) and in class quiz<\/b><\/span><\/span><\/span><\/p>\n

    Wednesday : History Presentation <\/span>GROUP ONE<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Please refer to the History Presentation file on BB.<\/span><\/span><\/span><\/p>\n

    Week 17 <\/b><\/span><\/span><\/span><\/p>\n

    Monday History Presentation <\/span>GROUP TWO<\/span><\/b><\/span><\/span><\/span><\/p>\n

    Wednesday <\/b><\/span><\/span>History Presentation <\/b><\/span><\/span>GROUP THREE<\/b><\/span><\/span><\/span><\/p>\n

    Please refer to the History Presentation file on BB.<\/span><\/span><\/span><\/p>\n

    Week 18 FINAL EXAM WEEK<\/b><\/span><\/span> <\/b><\/span><\/p>\n

    Please Refer to Final Exam Study Guide on CANVAS<\/span><\/span><\/span><\/p>\n

    Point distribution<\/b><\/u><\/span><\/span><\/span><\/p>\n

    1000-900 (90%) = A<\/b><\/i><\/span><\/span><\/span><\/p>\n

    899 – 800 (80%) = B<\/b><\/i><\/span><\/span><\/span><\/p>\n

    799- 650 (65 %) = C<\/b><\/i><\/span><\/span><\/span><\/p>\n

    649 – 480 (48%) = D<\/b><\/i><\/span><\/span><\/span><\/p>\n

    479 – 0 (FAIL) = F<\/b><\/i><\/span><\/span><\/span><\/p>\n

    Academic Integrity and Code of Conduct<\/b><\/span><\/span><\/span><\/p>\n

    Palomar College is wholly committed to the idea and ideals of academic integrity. We embrace and adopt the definition and related principles of academic integrity provided by the Center for Academic Integrity stated in <\/span><\/span>Section 4 Student Rights and Responsibilities <\/u><\/i><\/span><\/span> of the Palomar College Catalog.<\/span><\/span> For a full explanation of rights and responsibilities please refer to: <\/span><\/span><\/span>http:\/\/www.palomar.edu\/catalog\/2010\/4sturightsrespon.pdf<\/span><\/span><\/a><\/u><\/span><\/span> <\/u> as well as <\/b><\/span><\/span><\/span>http:\/\/www.palomar.edu\/Code_of_Conduct_condensed_version.pdf<\/span><\/span><\/a><\/u><\/span><\/span> <\/u> for the Student’s Code of Conduct.<\/span><\/span><\/span><\/p>\n

    Disabilities<\/b><\/span><\/span><\/span><\/p>\n

    The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection to persons with disabilities. This legislation requires that all students with disabilities are guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring accommodation please contact the Palomar College disability Resource Center (DRC) . For more information also see: <\/span><\/span><\/span>http:\/\/www.palomar.edu\/dsps\/<\/span><\/span><\/a><\/u><\/span><\/span> <\/u><\/p>\n

    For Add\/Drop information please go to: <\/span><\/span><\/span><\/p>\n

    http:\/\/www.palomar.edu\/admissions\/add_drop_sp.htm<\/a><\/b><\/span><\/span><\/span><\/p>\n

    History 108 Student information sheet:<\/b><\/span><\/span><\/span><\/p>\n

    Date:_____\/___\/_____<\/b><\/span><\/span><\/span><\/p>\n

    By signing this document I declare to have familiarized myself with:<\/b><\/span><\/span><\/span><\/p>\n