EX1 – University Exchange Programme
Application Form 2015/16
INSTRUCTIONS FOR APPLICANTS
 Applications should be typed.
 You must complete all sections. Please don’t forget to sign the application!
 Please include one passport-style photograph with your application.
 Not all programmes of study are available at all exchange partners. You must refer to the course approval
lists on the exchange website (http://www.stir.ac.uk/exchange/faqs) to see what partner universities offer
your particular programme of study. If you have a question about course compatibility, please email the
International Exchanges Team at studentexchange@stir.ac.uk before you submit your application.
 Return completed and signed forms to the Student Recruitment, Admissions and International (SRAI) office,
Pathfoot C3, by 12pm on Friday 5th December. Interviews for successful applicants will be held during the
week of 19th January 2015. Late applications will not be accepted. Please do not return your form by
email. Only signed paper forms with the required photograph will be accepted.
 There are strict academic requirements which must be met before you can apply to the UEP. You must be
on course for an Honours degree and have achieved grades of 2F or better in each module of your main
degree subject(s) in semesters 2 and 3 (plus at least two other grades of 2F or better in your second subject
in the case of Single Honours students). Students who have entered directly into the second year of a degree
programme at the university will need to meet these conditions for semester 3.
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 on the exchange programme, 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.
Applications which are incomplete or submitted past the deadline
will not be considered.
Page | 1
FINANCIAL INFORMATION & COST OF LIVING LOAN SCHEME
Students who go on exchange do not have to pay tuition fees at the host university but will have to meet all other
expenses. As an estimate, please refer to the table below for an idea of room and board and general living expenses
at our partner universities. Please note that these figures do not include airfare, insurance or vacation costs. Nor do
they cover extended in-country travel either before or after the period of exchange. You will see that the costs vary
depending on the location of the exchange partner university. The University of Stirling offers a needs-based shortterm loan scheme whereby we will provide the students with the amounts shown below prior to departure so that
up front expenses can be met. All loans must be repaid by the end of the student’s exchange period.
Please note – if you currently pay tuition fees to the University of Stirling, you will still have to pay this tuition
whilst you are on exchange as a student from the exchange partner university will take your place here at Stirling.
It is important that you check with your fee authority to verify whether they will continue to pay full fees for your
study abroad period.
Partner University
Akita International University (Japan)
University of Alaska - Anchorage
University of Alaska - Fairbanks
California State University Monterey Bay
Carleton University (Ottawa, Canada)
City University of Hong Kong
Flinders University (Adelaide)
University of Hawaii - Hilo
University of Illinois - Urbana Champaign
Kansas University
Kwansei Gakuin University (Osaka, Japan)
La Trobe University (Melbourne)
Le Moyne College (New York State)
Lingnan University (Hong Kong)
University of Louisiana – Monroe
University of Massachusetts - Amherst
University of Mississippi
Mount Allison University (New Brunswick, Canada)
University of New Mexico
University of North Carolina - Wilmington
University of Northern Iowa
Rikkyo University (Tokyo, Japan)
Ryerson University (Toronto)
Salisbury University (Maryland, USA)
San Diego State University
Simon Fraser University (Vancouver, Canada)
Sophia University (Tokyo, Japan)
University of Sydney
University of Toronto (Scarborough campus)
University of Victoria (British Columbia)
Waseda University (Tokyo, Japan)
Washington State University
University of Wisconsin (3 campuses)
University of Wyoming
Per
Semester
GBP £
3,500
3,600
3,600
3,600
3,600
3,500
3,500
3,600
3,500
3,500
3,500
3,500
3,500
3,500
3,500
4,000
3,500
3,500
3,500
3,500
3,500
4,000
4,000
3,500
3,600
3,600
4,000
3,900
4,000
3,600
4,000
3,500
3,500
3,500
Notes
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Mandatory health insurance requirement
Page | 2
COURSE COMPATIBILITY
Students earn credit towards their University of Stirling degree during the exchange and, as such, a student may only
study abroad at partner universities which are compatible with their University of Stirling degree. The exchange
website has comprehensive lists showing which exchange partners are suitable for which Stirling degree
programme. Students should also consult the individual website of the exchange partner to get more information
about available courses as information is subject to change without notice.
http://www.stir.ac.uk/exchange/faqs
Some degrees are easier than others when it comes to matching courses, and much depends on your chosen
exchange partner. You don’t need to get specific modules approved at this stage; it’s enough to know that the
exchange partner university you are considering has been approved by your academic division as an option. This will
be indicated on the spreadsheet as Y = Yes or P = Possible. The spreadsheet will also indicate whether an exchange
partner works with your degree in a joint honours capacity only. If you are on a joint honours degree, you need to
make sure that you are considering only exchange partner universities which are approved as a ‘Y’ or ‘P’ for each
subject.
Please note that, if you are selected as an exchange student it will be on the basis of your degree at the time of
application. You must advise the International Exchanges Team if you change your degree as this may affect your
eligibility to study abroad.
Page | 3
About You
Student ID#
Full name
Date of Birth
Street Address
City, Postcode
Contact Phone
University email
Other email
Intended Honours Degree (1)
Intended Honours Degree (2)
Have you accrued any points for Academic Misconduct?
Yes
No
If ‘Yes’, how many points?
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.
Page | 4
Duration of exchange
Students can indicate a preference for how long they would like to study abroad. In most cases, due
to the popularity of the UEP, only one semester placements will be offered. Please note that students
cannot participate in both the ERASMUS+ exchange programme and the University Exchange
Programme, although they can apply for both programmes initially.
I would like to study abroad for
1 semester only
2 semesters only
2 semesters preferred but happy with 1 if that’s
what’s available
I will also be applying for the ERASMUS+
programme
Partner University Selection
Please indicate the Universities for which you wish to be considered. List your first preference as 1
and the subsequent preferences in numerical order 2, 3, 4 etc. List only those for which your degree
is compatible and which you would be happy being selected for.
USA
University of Alaska Anchorage
California State University Monterey Bay
University of Hawaii - Hilo
University of Louisiana Monroe
University of Massachusetts Amherst
University of New Mexico
University of Northern Iowa
San Diego State University
University of Wisconsin Eau Claire
University of Wisconsin Stout
Canada
Carleton University (Ottawa)
Simon Fraser University (BC)
University of Alaska Fairbanks
University of Kansas
University of Illinois UrbanaChampaign
Le Moyne College (New York State)
University of Mississippi
University of North Carolina
Wilmington
Salisbury University (Maryland, USA)
Washington State University
University of Wisconsin La Crosse
University of Wyoming
University of Victoria (BC)
Ryerson University (Toronto)
University of Toronto (Scarborough
campus)
Mount Allison University (NB)
Hong Kong
City University Hong Kong
Lingnan University
Japan
Waseda University (Tokyo)
Rikkyo University (Tokyo)
Sophia University (Tokyo)
Akita University (Akita)
Kwansei Gakuin University (Osaka)
Australia
Flinders University (Adelaide)
La Trobe University (Melbourne)
University of Sydney
Page | 5
Permission to Disclose Personal Data for a Matriculated Student – DATA Protection Act 1988
Name
Student Number
Programme of Study
I authorize the University
of Stirling to disclose ANY
personal data
University Exchange Programme
(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:
(Please only select YES is the University can disclose information during
(a) unlimited by time
the whole of your matriculation for the above programme)
(b) valid until
Signed
Yes
No
(You only need to complete this section if you require the University to
release information for only a specific time period)
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.
Page | 6
About you
1. Please indicate what you would like to do after graduating (eg career path):
2. How do you feel that participating in the University Exchange Programme will contribute to your future plans?:
3. What interests / hobbies do you have? Please provide some detail:
Page | 7
4. Please list any clubs/societies/organisations you are a member of, and any offices you hold (university or nonuniversity). 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
Page | 8
EX2 – University Exchange Programme
Exchange Participation Contract
With reference to the offer of a place on the University 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 a full 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) Academic approval for study abroad;
b) Honours entry, confirmation of maintained Honours standing; or specific grades
required by University of Stirling departmental advisors;
c) Acceptance from the host University;
d) Appropriate arrangements for the repayment of the cost of living loan (if taken);
e) Completion of all required forms, submitted by the required deadlines;
f) Failure to gain entry to required courses at the host university.
OR
g) If at any time subsequent to the offer and prior to registration 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 the host university and the University of Stirling.
5. The Honours degree weighting for my exchange period is entirely at the discretion of the
appropriate authorities at the University of Stirling.
6. I will accept full responsibility for funding my own international travel, for any necessary
insurance, and 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 University of Stirling and may be required
to repay all, or part, of any funding provided.
Page | 9
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 register at the University of Stirling until all
debts outstanding from the exchange year are paid.
d) That I recognise that I am required at all times to maintain my Honours status by
achieving satisfactory grades at my host university which are acceptable to my
Honours Degree department or departments as being at least equivalent to the
grades specified for continuation in the Honours programme specified in the
degree regulations.
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 expended 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. On my return to Stirling I will attend a returnees meeting as scheduled by the International
Exchanges Manager to review the exchange period and agree to assist the University of Stirling
in promoting and supporting the exchange programme.
12. Prior to my departure for my host university, I will attend all briefing sessions organised by the
University to inform me of the procedures and information relating to the exchange year. I
accept that non-attendance at a briefing session without good cause may result in the
withdrawal of the offer of my exchange place.
This is a sample form for your reference only. You will be sent a blank EX2 form to be signed if
you are offered a place on the University Exchange Programme.
Page | 10