UNIVERSITÉ DU QUÉBEC À CHICOUTIMI
STUDENT EXCHANGE PROGRAM
APPLICATION FORM
A. STUDENT PERSONAL INFORMATION
Student I.D. Number Surname First name
INSTRUCTIONS
The Application Process:
Return the completed application to Études françaises by the deadline date. All sections must be
completed. Do not forget to include a one page personal statement. Your application will be
evaluated and you will be notified if you have been chosen for an interview.
Application deadline for 2017/2018: January 27, 2017
Pre-departure preparation:
If you are selected to participate in the Université du Québec à Chicoutimi Student Exchange
Program, you will be required to attend a pre-departure orientation session (PDO). You are also
expected to prepare yourself for your trip. Participants are responsible for the cost of travel,
supplementary health insurance, tuition and other incidental expenses.
If you move, you must notify the Études françaises office, 267 MacKinnon. If we cannot
contact you, you may not be allowed to participate in the program.
Be advised that:
Spaces are limited and are awarded on a competitive basis, subject to availability. Your application
does not guarantee that you will be interviewed or accepted.
You must maintain a 'B' average prior to your departure in order to participate in the exchange
program.
You will be required to attend a pre-departure orientation and sign a waiver prior to participating
in this exchange program.
If you apply by the deadline, you may be eligible for a Travel Scholarship based on your academic
record.
You will be required to pay full-time tuition fees and take four courses while on the Université du
Québec à Chicoutimi Student Exchange Program.
Note that you will receive a P(Pass) or F(Fail) in your transcript at UoG for each course you take at
UCAQ.
This form contains important information which you may need for future reference. Make
a copy and keep it in a safe place.