Application to Study Abroad - roanoke.edu

1 Carmen Boggs-Parker 540-375-2068 Application to Study Abroad Name: (Last) (First) (Middle) Student ID#: __ Birthdate: _____ Age: _____ Class standing: FR SO JR SR Expected Graduation (Month/YR): _____ Campus Address: Home Address: RC e-mail address: _____ Phone number: _ _____ Major(s): _____ Minor(s)/concentration(s): _____ _____ When do you intend to Study Abroad : Fall Spring Year Summer 20_____ Academic advisor: _____ Cumulative GPA: ___ _ _____ # of semesters taken in foreign language.

2 What language? _____ Campus organizations/sports in which you are involved: Do you have travel experience outside of the Yes No Specify: Study Abroad program(s) for which you are completing this Application : Yucatan Leipzig Other exchange or affiliate program. Locations/programs of interest: _____ Emergency Contact Name: _____ Relation: _____ Phone 1: _____ Phone 2: _____ Email 1: _____ Email 2: _____ Statement For the Yucatan & Leipzig programs, you must have a minimum cumulative GPA of to apply. For semester exchange or affiliate program, you must have a minimum cumulative GPA of A GPA of may be considered. If this applies to you, you must submit a letter of recommendation from a faculty member AND attach a written one-page essay explaining your current academic difficulties and your plan for improvement. (Student signature) (Date) Permission to review academic and conduct records: I give permission for the Office of international Education to review my academic and conduct records.

3 I understand that any serious issues will be considered in the selection process. I further understand that I must be in good academic standing both at the time of Application and start of the Study Abroad program in order to attend. I will not be allowed to Study Abroad if I am on conduct probation either at the time of Application or at the start of the Study Abroad program. If unable to Study Abroad , I will lose the money paid towards my program. (Student signature) (Date) Policy on unaffiliated programs: Roanoke College invests considerable time, effort, and resources in the creation of Study Abroad programs consistent with the needs of its students, with College standards, and educational objectives. Therefore, students will be expected to enroll in Roanoke College exchange, affiliated, or extension programs. If a student decides to enroll in an unaffiliated program, no Study Abroad benefits will apply. Student will be required to withdraw from Roanoke College during the semester Abroad .

4 As a result, no institutional or federal aid will apply for that semester. In addition, limited transfer credit policies apply. There will be no assistance from the international Education office for students who enroll in unaffiliated programs. Students will be responsible for all aspects of the Application process. (Student signature) (Date) Withdrawal policy: I shall be solely responsible for any and all costs arising out of my voluntary or involuntary withdrawal from the Program for reasons of health, family emergency, illegal drug or alcohol use or abuse, legal detention, or disciplinary action by official representative(s) of the Program or College. Costs incurred on my behalf include, but are not limited to, moneys advanced on my behalf for non-refundable deposits at other institutions, legal documents, any special fees (including the ISEP Application fee), and housing contracts.

5 If I withdraw, depart, or am dismissed from the Program for any reason prior to its formal completion, I will not be eligible for any academic credits. I further understand that the fees charged for the Program pay for the experience as a whole, and cannot be refunded for parts of it that I miss due to absence, withdrawal, and/or dismissal. Cancellation or withdrawal after the Program has started will result in the forfeiture of all fees. If I withdraw from the Program I will be responsible for paying any Program cancellation fees in full, regardless of whether those fees are directly billed to me by the Program, or billed to me by the College as a result of my withdrawal from the Program. (Student signature) (Date)