Registry
Collaborations and Study Abroad
WIYA: Pre-departure Agreement
This form must be completed and returned by all undergraduate students who are participating in a With Integrated
Year Abroad. Please complete electronically. You may either:
 Sign electronically and send to studyabroad@st-andrews.ac.uk from your St Andrews email account OR
 Print, sign and return to the CSA team at St Katharine’s West, The Scores
NB This document must be returned by 31 May at the latest.
1. Personal Details
Full Name
Student ID
Email
2. All students: Please tick to confirm you agree to the WIYA Terms & Conditions, available at: https://www.standrews.ac.uk/studyabroad/outgoingstudents/documentation/non-erasmusworkplacementdocuments/
I hereby confirm that I have read and agree to the Terms & Conditions.
3. All students: I hereby give my consent for the University to respond to any enquiries about my WIYA
programme from my next of kin contact while I am abroad.
YES
NO
4. This section is only for students working abroad in Europe. Please tick the correct statement.
a.
I have NOT received an Erasmus+ Mobility Grant before
b.
I have received an Erasmus+ Mobility Grant before.
If you ticked statement b, please give details, including when you received the grant and the nature of your
previous Erasmus+ placement.
5. All students: Signature and Date
St Katharine’s West, 16 The Scores, St Andrews, Fife KY16 9AX, Scotland
T: +44 (0)1334 462245/463310 F: +44 (0)1334 463330
E: studyabroad@st-andrews.ac.uk and collabs@st-andrews.ac.uk
W: www.st-andrews.ac.uk/studyabroad
The University of St Andrews is a charity registered in Scotland, No: SC013532