SAMFORD UNIVERSITY
INTERNATIONAL TRANSIENT ENROLLMENT FORM
FOR STUDY ABROAD STUDENTS
This form is for students who plan to study abroad at another institution or provider other than Samford University. PROCESS: Meet
with Samford Abroad advisor; consult with academic advisor; consult with financial aid advisor; complete form and obtain required signatures;
return form to the Global Engagement Office. (See page 2 for additional instructions.)
SU ID (900#): ______________________________
Prefix
(e.g.*HIST)
Course #
(e.g. *399)
Course Title
(e.g.*Special Topics)
Credit
Hours
SU Equivalent Prefix &
Course Number
SU Credit
Hours
Course Reviewed by
(Print Name)
Signature
SECTION C: TO BE COMPLETED BY COLLEGE ACADEMIC ADVISOR
SECTION D: TO BE COMPETED BY DEAN'S OFFICE (ONLY FOR SENIORS)
Seniors studying abroad with Samford partner, exchange, affiliate, or Non-Samford program must secure signed approval from their school Dean.
STUDENT ACKNOWLEDGMENT
I have carefully read and understand the information on this form. I further understand that it is my responsibility to request, from the transient institution, that it send an
official transcript to Samford University after I have completed the term. I acknowledge also that transient student status could have an effect on financial aid eligibility.
I authorize Samford University to release to the transient institution any transcripts that this institution may request.
Student Signature
Date
Date
Exchange Program Partner Program Affiliate Program
No, the student is not taking part in a Samford University approved study abroad program (Non-Samford program).*
*Courses reported on international transcripts may not be accepted by Samford University. Students taking part in a Non-Samford program are responsible for
requesting an international transcript evaluation from WES (www.wes.org) or AACRAO (www.aacrao.org). The evaluated international transcripts must be sent to:
Office of the Registrar, Samford University, Samford Hall 214, 800 Lakeshore Drive, Birmingham, AL 35229.
GEO Representative (Print Name)
GEO Representative Signature
Date
Date
SECTION E: TO BE COMPLETED BY FINANCIAL AID REPRESENTATIVE
All students participating in a Partner, Exchange, Affiliate, or Non-Samford program must meet with a representative from the Office of Student Financial
Services to determine the availability of financial aid and scholarships for this specific program. Financial aid advisor must sign below.
Yes, the student is taking part in a study abroad program with a Samford University approved provider who is authorized to report academic credit (choose from below).
SECTION F: TO BE COMPLETED BY GLOBAL ENGAGEMENT OFFICE
SECTION A: TO BE COMPLETED BY STUDENT APPLICANT
Name (First, Middle, Last): ______________________________________________________
___________________________
Financial Aid Advisor (Print Name)
Financial Aid Advisor Signature
Dean (Print Name)
Dean Signature Date
Advisor (Print Name)
Advisor Signature
Email Address: ________________________________________
Major:
City: ______________________
I am using a third-party provider.
Provider Name: _____________________________________
State/Province: ________________________
Country: ___________________________
Postal Code: ___________
Classification:
Freshman
I also request an Official Transcript to be sent to:
Spring, 20 ____
I request a Letter of Good Standing to be sent to:
Summer, 20 ____
Minor: ______________________________
Jan Term, 20 ____
Study Abroad Term:
Senior (See Section D)
Fall, 20 ____
Junior
Sophomore
Part B: (To be completed by Dept. Chair or Designee) Part A: (To be completed by student based on other institution’s coursework)
SECTION B: TO BE COMPLETED BY STUDENT AND SIGNED BY DEPARTMENT CHAIR OR DESIGNEE QUALIFIED TO REVIEW AND ARTICULATE COURSEWORK
Name of School/Program: _________________________________________
Address: ____________________________________________________
