Student Exchange Application

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Student Exchange

New American Colleges & Universities

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I. Biographical Information

Campus Address

Home Address

Mobile Contact Info

Emergency Contact Info

II. Home Institution / Academic Background

III. Host Institution
Check one institution’s program to which to apply.
(Separate applications are required for any additional programs.)

	SPRING	FALL
Arcadia University	Standard Curriculum Philadelphia Semester*	Standard Curriculum Philadelphia Semester*
Belmont University	Standard Curriculum	Standard Curriculum
Butler University	Standard Curriculum	Standard Curriculum
Drury University	Standard Curriculum	Standard Curriculum
Ithaca College	DC Semester*	DC Semester*
North Central College		Chicago Term*
The Sage Colleges	Standard Curriculum	Standard Curriculum
Samford University	Standard Curriculum
The University of Scranton	Standard Curriculum	Standard Curriculum
Valparaiso University	Standard Curriculum	Standard Curriculum
Wagner College	Standard Curriculum New York Semester*
Westminster College	Standard Curriculum	Standard Curriculum Winter at Westminster*

* Denotes special curriculum. For more details, see the program descriptions at www.newamericancolleges.org/anacsa/StudentExchange_Programs.html.

IV. Signature and Certification

I certify that the information on this application is accurate and complete. I have arranged for a transcript and letter of support to be sent to the Student Exchange Representative at the host institution.

I have reviewed the guidelines for the administration of this program including transfer of grades and any additional program fees. I understand that I am responsible for obtaining a transcript from the host institution and sending it to my home institution registrar. I will maintain an open line of communication with my home institution’s Student Exchange Representative and my home institution advisor.

V. Approval of Student Exchange Representative at Home Institution

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