Fillable Intent-to-extend INTENT TO EXTEND STUDY ABROAD PROGRAM

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Intent-to-extend INTENT TO EXTEND STUDY ABROAD PROGRAM

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INTENT TO EXTEND
I, _________________________, am requesting an extension of my program in
FULL NAME
___________________________. Originally I planned to study abroad during
CITY / COUNTRY
the _______________ semester of ______. I would now like to extend this to include
FALL/SPRING/SUMMER YEAR
the _______________ semester(s) of ______.
FALL/SPRING/SUMMER YEAR
In signing this form, I am agreeing to adhere to the same responsibilities and regulations
as set forth in the following documents signed by me for my original program plan:
• Program Agreement
I also agree to submit a new Financial Planning form.
_________________________________ _______________________
SIGNATURE DATE
_________________________________
PRINTED NAME
_________________________________
PROGRAM
(USAC or DIRECT EXCHANGE)
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Please fax this form with
“ATTN: Study Abroad”
on the cover page
- Our fax number from abroad is 001-530-898-6889.
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Intent-to-extend INTENT TO EXTEND STUDY ABROAD PROGRAM

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Completed 29 February 2020

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