Application for Exchange
Parent/Guardian Acknowledgement
Deadline Date for Student Priority Placement: 12/15/10
Application Deadline Date: 02/12/11
Parent/Guardian Acknowledgement received by WSU ___________(date)
Student’s Full Name
CWID#
SS#
DOB
An NSE Application for Exchange is not considered complete until a Parent/Guardian Acknowledge form is
completed and returned to the NSE Program Office at WSU.
Name of Institution
Tuition Payment Plan
Plan A=You pay in-state/resident tuition/fees to your host campus.
Plan B=You pay your normal tuition/fees to your home campus
A or B (Prefer – A or B)
1.
2.
3.
4.
5.
A only
A only
A only
A only
A only
B only
B only
B only
B only
B only
FOR INDEPENDENT STUDENT
In lieu of parent/guardian acknowledgement, I have attached proof of personal independence. Furthermore, I
have read and understand the contents of this form (pages 1 - 3).
Signature
Date
FOR PARENT/GUARDIAN OF DEPENDENT STUDENT
I hereby acknowledge that my son/daughter has informed me of their Application for Exchange. Student
applicants are required to read the NSE Directory of Exchange Opportunities containing eligibility
requirements, policies and procedures. Parents are referred to the NSE web site at http://www.nse.org/ (link to
Student Information for details). Student applicants are advised of meeting on campus at which time university
officials provide students with advisement on preparation for exchange. It is the responsibility of the student to
attend scheduled meetings and to follow through as advised by university officials. Furthermore, I hereby
acknowledge that I have read and fully understand the contents of this form (pages 1 - 3).
Legal Name of Parent/Guardian
Signature
Date
RETURN THIS FORM TO:
NSE Parent Guardian Acknowledgement 3 online
Rev: 08/10
Westfield State University
International Programs Office
Attn: Cynthia Siegler, Director
Parenzo 130 (Lobby)
577 Western Avenue
Westfield, MA 01086-1630
413 572 8819 (phone) 413 572 8967 (fax)
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Application for Exchange
Parent/Guardian Acknowledgement
Definition of Dependent vs. Independent Student - while many students think of themselves as
INDEPENDENT because they have their own house or apartment, file their own taxes, or receive little or no
support from parents, the United States Department of Education has a rigid set of criteria for defining an
INDEPENDENT student.
Regardless of how much support a student actually receives from a parent/guardian, s/he is still considered a
DEPENDENT student unless:
The student is twenty one years of age or older at the time of application; or
The student is married; or
The student has a child or other dependent who receives more than half their support from the student and
who also lives with the student; or
The student is enrolled as a graduate or professional student; or
The student is a qualified veteran of the U.S. Military (not on active duty); or
The student is an orphan or ward of the court or was a ward of the court until age 18.
If none of the above INDEPENDENT student criteria are met, the student is considered DEPENDENT. An
INDEPENDENT student must submit a personally signed Acknowledge form and proof of personal
independence (as inferred above).
National Student Exchange (NSE) is a Westfield State University sanctioned program designed to provide
students with the opportunity to study at other U.S. colleges and universities in the NSE network, without
having to pay the high cost of out-of-state tuition.
NSE participation is a privilege, not a right. While the Westfield NSE coordinator will make the final
determination regarding student eligibility, listed below are the minimal requirements for NSE participation. All
of these requirements are applicable at the time of application and in effect during the term prior to exchange:
full-time enrollment at Westfield State University, minimum home campus cumulative grade point average of
2.5 (4.0 scale), good academic standing as defined by Westfield State University, no incomplete grades from
pervious terms, no current or pending probationary status due to academic dishonesty or misconduct, no
current or pending probationary or disciplinary action for violation of codes of student conduct, no outstanding
financial obligations to Westfield State University. Student must not be on probation, parole, or have any
pending legal judgments. The student Application for Exchange and/or exchange placement is automatically
revoked if/when a student’s eligibility is compromised.
Application acceptance is subject to receipt of a completed Application for Exchange packet at the NSE
Program Office @ WSU. A completed Application packet includes: 1-NSE Application for Exchange, 1Application Fee paid ($150.00 CASH); 1-Program of Study Statement, 2-References (1-Academic Advisor, 1Other), 1-Unofficial Student Transcript, 1-Parent/Guardian Acknowledgement, and 1-Personal Interview.
NSE Parent Guardian Acknowledgement 3 online
Rev: 08/10
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Application for Exchange
Parent/Guardian Acknowledgement
Once an NSE placement offer is extended, a student must accept or decline the offer in writing. Upon
acceptance, the placement is secured and the student is expected to engage in full-time study at the host
campus for the full exchange term unless academic, financial or personal circumstances compel a student to
cancel. A student who declines the initial NSE placement offer may or may not receive additional offers from
other host campuses.
Tuition and related fees are paid in one of two ways. 1) Under NSE Plan A, students pay in-state tuition/fees
to the host school. 2) Under NSE Plan B, students pay tuition/fees to the home school as usual. Under Plan A
& B, student room & board charges are paid to the service providers. Applicants for exchange seeking student
financial aid, apply directly to the school that will receive their tuition payment. Plan A students apply to the
host school. Plan B students apply to WSU and should contact Student Administrative Services, x8542 for
information. To be eligible for financial aid, students must comply with all policies, procedures and eligibility
requirements. Campuses that award federally funded aid require students to complete a Free Application for
Federal Student Aid (FAFSA). A completed FAFSA identifies the home school and all potential exchange
schools and must be postmarked by 03/01/11. Financial aid award checks usually arrive at the home school
in mid-October. If a refund is due, students receive a University check mailed to their permanent address.
Refunds may be applied toward student expenses while on exchange. Be advised, however, that some host
school bills may come due before student award checks arrive. Students are referred to the NSE web site for
host school billing schedules and information on line at http://www.nse.org/scampusdetail.asp.
Students on exchange remain registered, degree-seeking students and, accordingly, they are subject both
home and host school rules and regulations. As such, exchange privileges may be revoked by either school
when academic or personal conduct leads to probationary status or student judicial action.
Academic Course Registration - in order to be sure that courses taken at the host campus will count toward the
student’s degree from WSU, the student is expected to complete a WSU Advising Agreement before
registering for academic courses at the exchange campus. Completion of this Agreement is the student’s
responsibility. WSU does not accept or assume this responsibility for the student.
Host campus communication - after an exchange placement offer is formally accepted, NSE host campus
coordinators provide information and instructions to each student who has accepted their exchange offer.
Students are expected to read and comply with all instructions and deadlines as required by the host campus.
Before contacting the NSE host campus coordinator, students are encouraged to direct their questions to
Westfield’s NSE coordinator. If further information is necessary, WSU will provide the student an appropriate
host campus referral.
Liability - Westfield State University is not liable for accidents or injuries a student may sustain in transit to and
from the host school or during a student’s exchange term. Students are advised to take all necessary steps to
ensure that they have adequate health and accident insurance for their personal protection.
Following each term of exchange, a student transcript containing all credit hours and grades earned on
exchange will be sent by the host campus to the Westfield State University Registrar.
NSE Parent Guardian Acknowledgement 3 online
Rev: 08/10
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