Student Exchange Program: Participation Agreement AU 2016/SP 2017 (Undergraduate)

Student Exchange Program: Participation Agreement
AU 2016/SP 2017
Instructions: Print this form, complete and scan. Combine with your Course Planning Worksheet, passport scan (if
applicable), resume, and your advising report to upload onto the online application under the “Advising Report” upload
Student Name:
OSU Email:
(Print Name)
Anticipated Graduation:
Current Rank: Sophomore / Junior / Senior .
(Specify Term)
Exchange Selection List
Please select your top three exchange locations and the term you wish to go abroad. To avoid delaying graduation,
students should not apply to participate in the exchange program in their graduating semester.
Institution Name
Term Abroad
Primary Exchange Location
AU 2016 / SP 2017
Secondary Exchange Location
AU 2016 / SP 2017
Third Exchange Location
AU 2016 / SP 2017
Participation Agreement
As an applicant for the Student Exchange Program, I understand the following.
As part of the Student Exchange Program, I will take classes at a host institution, where the course offerings are controlled by
that host institution.
The course equivalency information provided by the Office of Global Business is a list of course equivalencies that has been
approved in the past. This data is shared as a reference and is not a guarantee that these courses will be offered on the term I
go abroad, nor that these courses will equate to courses currently offered at Ohio State University. I acknowledge that there is
a possibility that I may only receive general elective credit during my term abroad, and I still desire to study abroad on the
Student Exchange Program.
I am responsible for coordinating my own program logistics, including but not limited to travel arrangements, student
visas/resident permits, accommodations, academics, financing, health, safety, and any other arrangements required for the
exchange program. I will do so following The Ohio State University, Host University, U.S., and Host country laws and
regulations, before, during, and after my exchange program.
I must have a passport valid at least 6 months past the end dates of travel to participant in the Student Exchange Program. If I
am a U.S. citizen and do not currently have a passport, I will apply for my passport as soon as possible. I understand that I
must have my passport by March 1, 2016.
I agree that the relevant information collected through the Student Exchange Program (i.e., passport information, name,
gender, date of birth and any other information necessary) may be shared upon request with partner universities solely as
required to facilitate my participation in the program. (i.e. nomination, academic planning, etc.)
If I am an international student, I understand that I must have a multiple entry visa to ensure my ability to re-enter the US after
the program. I am responsible for obtaining any visas required to travel and to come back to the U.S. to continue my studies at
OSU after the program. I also understand that there is a possibility that a valid U.S. visa may be requested to receive the Host
country visas. For any U.S. visa questions, I will consult an Office of International Affairs (OIA) Immigration Officer before
My signature below confirms that I understand and agree to the terms and conditions above.
Student Signature:
Last updated 8/20/2015