Haskell/KU Student Exchange
Program Application
Full-time KU Student ID:
Full-time HINU Student ID:
A00000
In an agreement with the University of Kansas, students from both schools have the ability to attend
classes at each university while being a full-time Haskell Indian Nations University or University of Kansas
student. This long-standing program is open to qualified students and all inquiries, approvals, and student
applications processed through the Office of the Registrar, Haskell Indian Nations University.
Student Information
Semester: Fall Spring Summer
Student Name:
Mailing Address:
Email Address: Telephone/Cell:
Emergency Contact Information
Name of Individual to notify in case of emergency
Last First MI
Mailing Address:
Email Address: Telephone/Cell:
Relationship:
Parent Spouse
Nearest Relative Other
Requirements of the Program
Haskell Students KU Students
Students are required to pay for parking, books, lab fees
and other expenses as normally required of a student at
the University of Kansas
Must be in Good Standing
Must have a 2.50 Cumulative GPA Can only take one (1) class per semester
Must be in Good Standing
Must adhere to Haskell Academic Calendar including
application deadlines, drop/add periods, withdrawal
Must meet all pre-requisites for KU class, refer to website
www.classes.ku.edu for information
Must have Advisor Signature
Can only take courses not offered at Haskell
Must adhere to KU Academic Calendar including
application deadlines, drop/add periods, withdrawal
Note: Neither KU or Haskell courses are guaranteed. Students must enroll full-time (min. 12 hours) and maintain this
schedule until they are notified of the approved KU/Haskell course.
Haskell Indian Nations University | Office of the Registrar | 155 Indian Avenue, Box #5020, Lawrence, KS 66046
TEL: 785-749-8440 | FAX: 785-832-6622 Email: registrar@haskell.edu | www.haskell.edu
Haskell Indian Nations University | Office of the Registrar | 155 Indian Avenue, Box #5020, Lawrence, KS 66046
TEL: 785-749-8440 | FAX: 785-832-6622 Email: registrar@haskell.edu | www.haskell.edu
First Choice
Haskell Indian Nations University
Dept. Crs. ID Section Course Name Credits
The University of Kansas
Course ID Course Name Type Time, Place, and Instructor Credit Hours Class # Pre-Req’s
Second Choice - If approved for first choice, second choice will not be an option of enrollment.
Haskell Indian Nations University
Dept. Crs. ID Section Course Name Credits
The University of Kansas
Course ID Course Name Type Time, Place, and Instructor Credit Hours Class # Pre-Req’s
By signing this form, I agree to follow the rules and policies of Haskell Indian Nations University and the guidelines of the
University of Kansas Student Exchange Program. I understand that my transcript may be provided to Exchange Program
Coordinators from both schools to determine if I meet the pre-requisites for the class I am requesting.
Student Signature Advisor Signature
Date Date
Haskell Students - Please respond or provide requested information:
1. Provide a completed degree check sheet along with this application.
2. In a brief type written statement on a separate sheet of paper, describe how this course will facilitate
the success of your academic program
3. Do you have reliable transportation to the University of Kansas campus? Yes No
4. Did you know there is a dedicated Lawrence bus from the Haskell campus to KU and back?
Yes No
Haskell/KU Student Exchange
Program Application
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