EX1 Application Form
USAC Summer China Programme /

INSTRUCTIONS FOR APPLICANTS

Þ  Please complete applications clearly in black ink. Applications should be typed.

Þ  You must complete all sections. DO NOT FORGET TO SIGN THE APPLICATION.

Þ  Please attach one passport-style photograph to your application.

Þ  Please hand in completed applications to the Student Hub (Cottrell 2A1) no later than Thursday 9th March. Decisions on applications will be made shortly after the deadline.

Þ  Not all programmes of study are available at summer exchange partners. Please refer to the attached programme information leaflet for more information

USAC Shanghai

usac.unr.edu

4 week summer session

June 26 – July 30 2017

EXCHANGE PROGRAMME PARTICIPATION CONTRACT (EX2)

The attached EX2 is for reference only and should not be returned with your application form. Please keep this for your reference. If you are offered a place as an exchange student, it will be on the basis that you agree to abide by the terms outlined in this document and you will be asked to sign the EX2 form at that point.

FINANCIAL INFORMATION & MOBILITY GRANT AWARD

The USAC programme fee is waived for summer exchange students. Students will also receive a travel grant from the University of Stirling that will cover a significant part of their international airfare costs. All other costs are the student’s responsibility and estimates are provided in the programme information leaflet.

COURSE COMPATIBILITY

Students will study 6 US credits over their summer session at the exchange partner university. These courses will not be applied towards your University of Stirling degree but students will receive a USAC transcript detailing the courses studied and marks obtained. Students will also have their participation recorded on the supplementary page of their University of Stirling transcript.

Applications which are incomplete or submitted past the deadline will not be considered.

About You
Student ID#
Full name
Date of Birth
Street Address
City, Postcode
Contact Phone
University email
Other email
Intended Honours Degree
Name and address of Education Authority or other body to which you apply for fee support (e.g. SAAS, Student Finance England etc.)
Name
Street Address
City, Postcode
What are your main sources of funding at present?
Confidential
Do you have any disability or special need for which you would require support if selected to participate in the exchange programme? Please provide details on a separate page if you answer ‘Yes"
Yes No
Selection for the University Exchange Programme is made on academic and personal merit and follows the principles of equal opportunities in relation to factors such as gender, race, disability, religion, sexual orientation, etc. Completion of the above is required only so that any special arrangements can be arranged with your host University if required.
Permission to Disclose Personal Data for a Matriculated Student – DATA Protection Act 1988
Name
Student Number
Programme of Study / University Exchange Programme
I authorize the University of Stirling to disclose ANY personal data / (Please provide the names of the person(s) to whom the University can disclose all information on your student record for the programme of study above EG Parents / Carer / Partner / Exchange University (if selected))
This authority to disclose personal data is:
(a) unlimited by time / (Please only select YES is the University can disclose information during the whole of your matriculation for the above programme)
Yes No
(b) valid until / (You only need to complete this section if you require the University to release information for only a specific time period)
Signed / Date
This information will be provided to the Student Matriculation and Records Office. Student Administration Action: Form to be retained securely for the period: end of the individual’s relationship with University + six years. Form to be stapled to the front cover of the student file once SPD updated.
We ask for this information so that, if you are selected to go on exchange, we can speak to your parents / carer / partner should they call with questions about your participation. Once on exchange, time differences can mean that they may need to contact us on your behalf, and we cannot speak with third parties about you without your express permission. Giving us this permission at the earliest stage helps avoid difficulties further down the line.
About you
1. Please indicate what you would like to do after graduating (eg career path):
2. How do you feel that studying abroad will contribute to your future plans?:
3. What interests / hobbies do you have? Please provide some detail:
4. Please list any clubs/societies/organisations you are a member of, and any offices you hold (university or non-university). If you are not a member of any, please say why:
5. Is there any other information that you would like the selectors to take into account?
Attached statement
Please attach to this application a typed personal statement, in no more than 500 words, answering the question: ‘What makes you a good ambassador for the University of Stirling?’
Agreement and Signature
By submitting this application, I agree that if I am selected to participate in the University Exchange Programme I will abide by the EX2 Exchange Participation Contract and any other conditions of the programme.
Name (printed)
Signature
Date
EX2 – Summer Exchange Programme
Exchange Participation Contract /

With reference to the offer of a place on the Summer Exchange Programme, I wish to inform you that I accept this offer and in doing so, accept the conditions of the offer as stated below:

1.  As a representative of the University of Stirling I will pursue diligently the required course of study at my host university during the period of exchange. I acknowledge that this commits me to sitting all exams and submitting all coursework as may be required of me as a member of the host institution’s student body.

2.  I understand that the offer may be withdrawn at any time prior to registration at the host university if I fail to secure any of the following:

a)  Honours entry, confirmation of maintained Honours standing; or specific grades required by University of Stirling Advisers of Study;

b)  Acceptance by the host university;

c)  Completion of all required forms, submitted by the required deadlines;

d)  Failure to gain entry to required courses at the host university.

OR

e)  If at any time subsequent to the offer and prior to enrolment the scheme becomes financially unviable or is otherwise closed and I accept that such decisions are taken at the absolute discretion of the university.

3.  I understand that, should I be unable to continue on the exchange programme after having purchased flights / visas etc, these costs are my own responsibility and cannot be reimbursed by the University of Stirling.

4.  I will take such courses and classes, and undergo such examinations and tests as are required by my host university and the University of Stirling, and conform to the disciplinary codes and regulations of both the host university and the University of Stirling.

5.  I understand that the courses taken during the Summer Exchange Programme are not applied towards my University of Stirling degree.

6.  I will accept full responsibility for funding my own international travel (unless covered in full by a mobility grant), accommodation and living expenses, for any necessary insurance, and for any visa fees. I will accept full responsibility for the proper disbursement of any funds granted to me for the duration of my programme, knowing that I may be liable to repay such sums as might be judged to have been misspent or paid to me in error.

7.  I accept that:

a)  If I withdraw from my host university without prior consultation I will be deemed to have withdrawn from the summer exchange programme and may be required to repay all, or part, of any funding provided.

b)  If after my return to the University of Stirling I do not complete my degree course, I may be held liable to repay to the University of Stirling such sums as may have been expended to enable me to study for the academic session at the host university unless I show good cause for my termination of study. I understand that ‘good cause’ will be determined by the Academic Council and the University Court.

c)  That if I am in debt to the University of Stirling at the end of my exchange period, I will not be permitted to enrol at the University of Stirling until all debts outstanding from the exchange period are paid.

8.  I shall send (and am aware that it is essential to send) regular reports to the International Exchanges Manager, giving academic information as might be requested of me; and shall answer any reasonable request for information which might be made of me. I shall retain copies of all documents sent to the University of Stirling and am responsible for checking on the safe arrival of any required document and for the replacement of any missing documents.

9.  I shall be prepared to undergo and, if necessary, pay for a medical examination which may be required by my host university.

10.  I shall make arrangements for the purchase of such insurance as I and my host university deem necessary to cover all medical and dental expenses incurred overseas and I understand that the University of Stirling is not responsible for and will not pay for any such expenses. I also undertake to obtain suitable travel and personal possessions insurance.

11.  Prior to my departure for my host university, I will attend any pre-departure orientation sessions organised by the University to inform me of the procedures and information relating to the exchange.

Signature
Printed name
Date
Student ID number