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FINANCIAL AID OFFICE
214 Center Grove Road,
Randolph, NJ 07869
Phone: 973-328-5230 Fax: 973-328-5237
Email: finaid@ccm.edu
“MOBILITY”
STUDY ABROAD/CONSORTIUM AGREEMENT
STUDY ABROAD DISBURSEMENT REQUEST FORM
This form must be completed by the student in order for the home institution (County College of Morris) to process
Federal, State and Institutional aid, based on your enrollment at an “approved” foreign institution.
Please read and sign the colleges’ financial aid procedures, agreement, terms and conditions on the back of this page.
Student Information- Please Print:
Name of Student: ____________________________________ CCM ID#: _______________________________________
Home Address: ____________________________________ E-mail: _______________________________________
Study Abroad Address: __________________________________________________________________________________
Dates of Enrollment: From ______ to _______ Term: __________ Major: _____________________________________
Enrollment: 12 or more ____ 9-11cr ____ 6-8cr ____ 3-5cr _____ other _____ Academic period (2011/12): _________
Signature: _________________________________________________ Date: ________________________________
TO BE COMPLETED BY THE HOME INSTITUTION (CCM)
“FOREIGN HOST INSTITUTION INFORMATION- Completed by CCM Study Abroad Adviser:
Name of Foreign School Contact: __________________________________________________________________________
Telephone number: ____________________________________________________________________________________
Foreign School Name: ________________________________________________________________________________
Address: ____________________________________________________________________________________________
**CCM-Study Abroad Adviser Signature: _________________________________ Date: _____________ Ext. _________
TITLE IV AID INFORMATION- FINANCIAL AID OFFICE USE ONLY:
Pell Grant $_______________ Federal Stafford Loan $ ___________________
SEOG $ _________________ Federal Unsubsidized Loan $ ________________
Other Aid $ ______________ (indicate type) ______________________________________
Pell Grant cost of attendance for the academic year: ______________________
Institutional (mobility) budget for campus-based financial aid for the period of enrollment: ______________________
Total number of credits enrolled for: Fall: _____________ Spring: ______________
Dates/terms of enrollment: Fall: _____________ Spring: ______________
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“MOBILITY”
STUDY ABROAD AGREEMENT PROCEDURES
Students wishing to study at another institution, as part of their program of study at County College of Morris should
follow the steps outlined below.
The fully executed Study Abroad Agreement, and all paperwork (processed FAFSA, verification requested items-
i.e. Copy of filed tax forms, proof of citizenship, worksheets etc.) related to the determination of financial aid, must
be completed and received by the Office of Financial Aid, at least 30 days prior to the enrollment period in which
you plan to study abroad.
a) Obtain a brochure or written documentation outlining the (external) course/s you are interested in.
Contact the **Study Abroad Advisor: Professor, James Hart Phone: 973-328-2486 Office location: DeMare
Hall, Room DH-207 and request approval for your planned courses. This form must be submitted for completion
by Professor, Hart or designee and returned to the Financial Aid Office for final verification and approval that the below
student named, will receive full credit(s) towards s/her degree at CCM for all credits taken at the foreign school.
b) It is very important that any financial aid application materials or request’s for additional information by the office, are
received prior to traveling. If all documents are not received, it will delay the crediting of funds, which may lead to late
CCM penalty charges. Late payment charges accessed by the college’s bursar will be your responsibility before
departing.
c) You should make payment arrangements with your Host Institution. If the Host Institution is willing to defer any or all
of the direct tuition cost, based on expected financial aid. Please note that CCM Bursar Office will not process your
refund, until your class attendance has been verified and aid has been credited to your CCM account.
d) The Office of Financial Aid recommends that you also make arrangements prior to leaving the US with a family member
(suggested); allowing them the ability “power of attorney” to endorse and deposit your check, while you are abroad.
e) The above process ‘c’ and ‘d’ involves the receipt of all external funds, federal stafford loan- Electronic Fund Transfer
to the college (if applied). The receipt of proof that you are/were in attendance, must be verified by CCM Study Abroad
Advisor. Make sure the Bursar and the Records/Registration Offices have your ‘currentUS address and
telephone number while abroad.
f) Once your attendance is verified, your aid will be disbursed. In the event you are expecting a refund from CCM,
based on your financial aid; a refund check will be mailed to you (US address) in approximately two (2) weeks
after aid has been credited by the Bursar’s Office (973/328-5115 or 5117).
g) Your financial eligibility will be reviewed based on the actual or anticipated costs of the “Mobility Program”.
Financial aid adjustments may be made, depending on cost of the mobility program. The financial aid staff will
continue to work with you to determine what aid, if any, is approved prior to your departure.
h) Upon completion of the program, you must have an official academic transcript sent from the Foreign Institution to the
Office of Records and Registration - County College of Morris.
CCM FAA Rev.052013
I ______________________________________________, have read and understand all of the above terms and conditions and
agree to follow the rules as outlined by the County College of Morris and the Host Institution.
_____________________________________________________________ ________________________
Print Name CCM ID# Anticipated enrollment period
_____________________________________________________________
Signature Date
_____________________________________________________
Telephone (US) (Foreign)
_____________________________________________________
E-mail
___________________________________________________________________________________________
USA Contact- Name and Phone number (Emergency)
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