Student Exchange Program Application

PILON SCHOOL OF BUSINESS

Student Exchange Program Application

PERSONAL INFORMATION

Last Name: ______Given Name: ______

Student #: ______Credit Hrs: Completed: _____ Enrolled in: _____

Degree Program: ______Current GPA: ______

Current Address: ______

City/Town: ______Province: ____ Postal Code: ______

Telephone: ______Email (1): ______

Email (2): ______

PARTNER INSTITUTION

1st Choice - Host University: ______

Location: ______

2nd Choice - Host University: ______

Location: ______

Sheridan Equivalent Term: □ Fall/Winter ____ □ Winter/Spring ____ □

(*availability of Term will depend upon Host University schedule and Sheridan approval)

Proficiency AWARDS AND EXTRACURRICULAR ACTIVITIES

*Please list academic awards you have received and indicate extracurricular activities.

PERSONAL STATEMENT

Personal Statement (Please explain your interest in participating in a student exchange program).

(This section should not be greater than 200 words in length)

DECLARATION

I declare that the information submitted is correct and complete. I realize that the decision about participation will depend upon the Exchange Committee and that my application does not obligate me to participate should I be selected. My application to the Host Institution will be treated as my intent to participate in the Exchange Program should I be selected by the Exchange Selection Committee.

Student Signature: ______Date: ______

Name Printed: ______

STUDENT AWARENESS
STUDENT CODE OF CONDUCT

I acknowledge that while I am on exchange, I am bound by the Sheridan College Student Code of Conduct, both academic and non-academic, as well as any Code of Conduct in place at the Host Institution.

UNDERSTANDING OF FINANCIAL OBLIGATION

I acknowledge that I am aware of the additional financial obligations of participation in an Exchange. Tuition for the study abroad is covered by your payment of Tuition for the Term of study to Sheridan. Additional costs including travel to/from the Host Institution, living and personal expenses while abroad are the financial obligation of the student. I further understand that it is my personal obligation to pursue financing, both personally and through avenues available through Sheridan College, for the purpose of fulfilling an Exchange should I be selected to participate.

Personal Statement (Please explain your initial thoughts of how you plan to cover the costs of participation in an Exchange).

(This section should not be greater than 100 words in length)

UNDERSTANDING OF ACADEMIC COURSE LOAD

I acknowledge that a successful candidate for an Exchange will need to confirm an acceptable course load with Faculty Advisors at Sheridan and accepts the terms and conditions as related to successful completion of study abroad and the transfer of such achievement back to Sheridan on the terms and conditions explained at the time of acceptance.

I acknowledge the foregoing STUDENT AWARENESS:

Student Signature: ______Date: ______

Name Printed: ______

Please submit the completed application to Professor Stan Kamzol, Pilon School of Business (pdf format) and hard copy to the attention of Professor Stan Kamzol, Academic Exchange Coordinator, Pilon School of Business, Sheridan College, Room 406, 4180 Duke of York Blvd., Mississauga, Ontario L5B 0G5

Application Deadline: Tuesday, January 31st, 2017