Submit by Email University Honors College Study Abroad Scholarship Acceptance Form Full Name: Student ID: Award Amount(s): PLEASE READ CAREFULLY AND SIGN BELOW This award is dependent on the determination of the Financial Aid Office as to whether a student can receive additional funding. If the award is released and a student then chooses not to go on a study abroad program, a hold will be placed on the student's account until the full scholarship is repaid. If a student should choose to withdraw and return to the U.S. before completing the designated program, this student will be required to repay all scholarship money in full. If it is not repaid, the hold on the student's account will remain until the full scholarship is paid. Students must use all scholarship funds toward the study abroad program identified on their MTSU study abroad scholarship application. These funds cannot be used for any other purposes. If there is a balance on the student's MTSU account, the scholarship will automatically go toward this balance first. Students receiving a scholarship for an entire academic year program will receive one half (1/2) of the award amount in the Fall semester, and the remaining one half (1/2) in the Spring semester. If a student chooses to withdraw from a year-long program and return to the United States after the completion of one semester, then that student will forfeit the second installment of the scholarship. Scholarships will be released into student accounts on the APPROXIMATE times below: Spring Study Abroad Programs: (mid January) Summer Study Abroad Programs: (early April) Fall Study Abroad Programs: (late August/early September) Full Academic Year Study Abroad Programs: (late August/early September) The award will not be released into the student's account until this form is signed and submitted. By signing my name below, I acknowledge I have read the above information and agree to comply with these requirements. Signature of Student Date Signature of Honors College Academic Advisor Date Signature of Dean, University Honors College Date A Tennessee Board of Regents Institution MTSU is an equal opportunity, non-racially identifiable, educational institution that does not discriminate against individuals with disabilities. 11/16/2012 Print Form