Nassau Community College
Study Abroad Application
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The Office of Judicial Affairs, in conjunction with the Office of International Education, will render a
decision based on the severity of the violation, to determine the student’s eligibility to participate in the
study abroad program.
Have you ever been convicted by federal, state, military or other law-enforcement authorities, for any
violation of any federal, state, county or municipal law, regulation or ordinance?
¨ Yes ¨ No
If yes, please explain. __________________________________________________________
As a participant of a study abroad program, I am subject to ALL “Code of Conduct” rules, as per the
Nassau Community College catalog. Usage or any involvement with illegal drugs or narcotics is cause
for immediate dismissal from the program and possible dismissal from Nassau Community College.
If I cause damage to the facilities being used by me during the time of my participation in this study
program, I understand that I will be held personally liable for any repairs required of the facility. In the
event that I do not reimburse the facility for said damages, I understand that Nassau Community
College will IMPOUND my school records (will not release them) until such time as restitution is made
If I leave the program voluntarily or am asked to leave at the request of the Program Director, I fully
understand that no refund will be made, and I am responsible for arranging and paying for return travel.
WAIVER OF LIABILITY: In the event that I elect to stay in (country) ____________________________
beyond (the end date of the program)_________________________, I understand that Nassau
Community College assumes no responsibility for any of my actions or the results therefrom. Therefore,
I understand that I will assume complete and total responsibility for all my actions beyond my
participation in (course/program) ____________________________.
Prior to final acceptance ALL applicants will be screened for requirements, i.e. GPA, completion of all
required remedial courses and minimum course requirement as stated in the program/course
ALL registrations are processed through the Office of International Education.
ALL bills must be paid in full upon receipt, (prior to departure) or students will be dis-enrolled without any
reimbursement of prior deposits.
The undersigned acknowledges that s/he has read the above, and that all statements made are correct
to the best of her/his knowledge.
Applicant’s Signature: ______________________________________ Date _______________
Parent’s or Guardian’s Signature (only necessary if the applicant is under 21 years of age):
_______________________________________ Date _______________
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