Guaranteed Admissions Transfer Program (GAT) University of Illinois at Chicago (UIC) and City Colleges of Chicago (CCC) Student Participation Agreement 1. Planned first term of enrollment at UIC: 2. Full Legal Name: FALL 20_____ (do not abbreviate or use nicknames; domestic student’s name must match name on social security card; international student’s name must match passport information) _______________________________________________________________________________________________________________________ Last (Family, Surname) First (Given) Middle 3. Current Mailing Address _______________________________________________________________________________ Number and Street or Rural Route Apt. No. ________________________________________________________________________________________________________________________________________ City or Town State (or Country) Zip Code 4. Permanent Mailing Address check box if permanent mailing address is the same as current mailing address _______________________________________________________________________________ Number and Street or Rural Route Apt. No. ________________________________________________________________________________________________________________________________________ City or Town State (or Country) Zip Code 5. Date of Birth Gender Month Male Female Year Day 6. Telephone Numbers / Email _______________________________________________________________________________________ Home Telephone Cellular Number (optional) Email Address UIC sends official University communications through email. Please make sure you provide a valid email address. 7. Planned Course of Study Please indicate the UIC College or area in which you plan to pursue your baccalaureate degree at UIC. Business Administration Engineering Education Liberal Arts and Sciences (Choose this if you plan to major in a LAS program or if you are undecided about your degree plans.) UIC – CCC GAT Program Student Participation Agreement UIC_OSSS_SSD_Admissions_GAT_Nov2011 Page 1 of 2 8. Program and Participation Requirements I understand that as a GAT participant, I am: Required to maintain a minimum cumulative grade point average of 3.00 on a 4.00 grading scale on all transferrable course work taken at the City Colleges of Chicago. Expected to enroll at CCC full time (12 or more semester hours) each semester in course work that meets UIC transfer requirements toward the intended baccalaureate degree or is a pre-requisite for UIC requirements. Expected to track my degree progress by creating an account in u.select, a web-based tool used to view program requirements and transfer equivalencies, and to import my courses to u.select at the completion of each term. (Enter your u.select ID in the space provided below.) Expected to attend GAT-sponsored activities on the UIC campus prior to transferring. Able to have some access to select UIC facilities in order to participate in GAT transfer-related academic activities. With my signature below I allow UIC and CCC permission to share transcripts for the purpose of Reverse Transfer. Reverse transfer allows students who did not complete their Associates Degree in the City Colleges of Chicago to use their UIC credits to complete a CCC degree. I also understand that: Each GAT cohort is scheduled for a fall term of enrollment at UIC. I must submit a UIC transfer application for admission not later than February 1 for the following fall term in the year I plan to transfer. All required application materials and supporting credentials, including a consolidated transcript from the City Colleges of Chicago, must be received by UIC no later than February 15. ______________________________________________________________ _______________________ _______________________ Student Signature u-select ID Date CCC Advisor This student is approved for participation in the GAT program for the Fall _________ cohort. _______________________________________________________________________________ ________________________________ Advisor Signature Date _________________________________________________________________________ City College of Chicago Location For UIC Office Use Only: UIN: ___ ___ ___ ___ ___ ___ ___ ___ ___ Date: __ __ / __ __ / __ __ __ __ UIC – CCC GAT Program Student Participation Agreement UIC_OSSS_SSD_Admissions_GAT_Nov2011 Initials: ______ Page 2 of 2