FFACON; FSPCON; FSUCON
Instructions: Please complete Section I of this form before forwarding it to the Host Institution for completion of Section II. Consortium agreements
are valid only for the specific period indicated. A separate agreement is required for each individual academic term.
Section I: STUDENT INFORMATION (To be completed by the Student)
Name of Student: ________________________________________________ UMGC Student ID:
Name of Host Institution: __________________________________________ Host Student ID: ________________________
Consortium Period Calendar year: 20_____ Academic term: [select one] Summer Fall Spring
Course(s) to be taken at Host Institution: ____________________________________________________________________________
Student Certification: By signing this agreement, I attest that the courses listed above are intended to count towards completion of
a degree or certificate program at University of Maryland Global Campus (UMGC). I understand that I am responsible for paying any
tuition, fees or other expenses incurred at both schools. I agree to inform the UMGC Financial Aid Office of any changes in enrollment
and acknowledge that I am responsible for providing UMGC with an official transcript from the Host Institution at the conclusion of
the consortium period. I authorize the Host Institution to confirm my enrollment and to provide UMGC with the information
requested in Section II below.
I, the Student, agree to:
• Complete the Permission to Enroll at Another Institution form to confirm that permission to take courses at the
Host Institution was officially granted by UMGC Academic Advising.
• Notify the UMGC Financial Aid Office of any changes in my enrollment level at either school.
• Authorize the Host Institution to release any information requi
red to finalize my financial aid at UMGC.
• Take responsibility for payment arrangements at the Host Institution.
• Have all of my federal and state financial aid processed only at UMGC for the duration of the Consortium Period.
• Submit an official transcript to UMGC no more than 30 days after the end of my classes at the Host Institution.
Student Signature: _______________________________________ Date: _______________
Section II: HOST INFORMATION (To be completed by the Host Institution)
The student listed above is seeking a degree or certificate from UMGC and plans to enroll at your Host Institution. The student wishes to
use financial aid funds to help cover the course(s) listed as part of their Consortium Agreement. As the student’s Home Institution,
UMGC will be responsible for determining eligibility of awards, disbursing aid, monitoring academic progress, keeping records, returning
funds, and reporting federal requirements. This Consortium Agreement will allow UMGC to disburse financial aid based on the
student’s combined enrollment at both institutions. Once any balance due UMGC has been paid, UMGC will refund any excess
financial aid to the student. Funds are not transferred from one school to another; the student is responsible for payment of all
charges at the Host Institution. The Host Institution agrees to provide UMGC with the following information.
Name of Host Institution: ____________________________________
Enrollment Period: Summer 20____ Fall 20____ Spring 20____
Dates of Enrollment: from ______________ to _____________
Number of Credits Enrolled In: ___________
Room and Board: $____________________
Books and Supplies: $____________________
Total Cost of Attendance: $____________________
Host Institution Certification: The Host Institution agrees NOT to process federal student aid for the student named in Section I.
___________________________________________________________________ _____________________________________________ ___________________
Name and Title of Authorized Official Signature (must be signed by hand, not typed) Date
E-mail Address Telephone Number
UMGC Financial Aid Office | 3501 University Boulevard East, Adelphi MD 20783 | help.umgc.edu