Scholarship Award Response
Office of International Programs
Study Abroad
Office Use Only
Award Amount: ____________
Registration: _____________
Recipient Information (please print):
Name:
_______________________________________________
Address:
_______________________________________________
_______________________________________________
SAM ID# (only): ___________________________________________________
(Not your username or Social Security Number)
Please Check One: Faculty-led Program _____
Full Semester Program____
Independent/Exchange Summer Program ______
Destination Country: _______________________________________________
FACULTY-LED PROGRAMS ONLY- Courses that will be taken while abroad:
___________________________________
(Put title and CID # for each course)
____________________________________
(Put title and CID # for each course)
EXAMPLE: SPAN 4365
EXAMPLE: SPAN 4365
Please initial one statement (Do not check):
_____ I accept the scholarship and the terms of the scholarship per my signed Acceptance Agreement without
Initial reservation.
OR
_____ I must decline the scholarship.
Initial
IMPORTANT Before your scholarship can be disbursed, you will have to have registered in the SHSU study
abroad course(s) for faculty-led & exchange programs. For independent programs, you have to have submitted
the course equivalency forms to the Study Abroad Coordinator and accepted at the university abroad.
PLEASE RETURN THIS FORM AS SOON AS POSSIBLE
(mail, fax, email, or hand-deliver)
MAIL:
Office of International Programs
Attn: Study Abroad
SHSU Box 2150
Huntsville, TX 77341-2150
FAX:
936-294-4620
Attn: Study Abroad
EMAIL:
jml084@shsu.edu
OFFICE:
Farrington 116