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STUDY AWAY APPLICATION DOMESTIC EXCHANGE (Bennington College)

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STUDY AWAY APPLICATION – DOMESTIC EXCHANGE
Instructions: If you wish to participate in an international exchange program, complete
this application and return it to the Study Away Office (Barn 120C) by September 7 for
spring programs, February 15 for fall programs.
In addition to this application, you must complete your host school’s application and their
deadlines vary. Students nominated for an exchange will receive instructions on how to
complete these applications.
Exchange Program: Check each program for which you wish to apply.
___ Champlain College ___ Norwich University
___ Evergreen State College ___ Prescott College
___ Goddard College ___ Rochester Institute of Technology
___ Fairhaven College/Western Washington Univ ___ St. Michael’s College
___ Hampshire College ___ Sterling College
___ Landmark College ___ University of Redlands
___ Marlboro College ___ Westminster College
___ Middlebury College
___ New College of Florida
___ New College/Univ. of Alabama
___ New England Culinary Institute
Application Checklist:
❑ Study Away and the Plan: Speak with your faculty advisor as soon as possible to
discuss your proposed study away and determine if a Plan meeting is necessary.
❑ Letter of Recommendation: Ask your faculty advisor or a plan committee member to
complete the attached recommendation form and submit it with your application.
❑ Study Away Essay: Submit a revision/addendum to your Plan essay. Explain your
reasons for studying away, the program you have selected and courses you will pursue.
Explain how this work will support, enhance, or inform your studies. Attach a copy of
this essay.
❑ Proposed Course of Study Form: Complete this form and bring it with you when you
meet with your faculty advisor and Plan committee members.
❑ Declaration of Agreement: Read carefully and sign. Parent/guardian signature is
required for all applicants regardless of age.
❑ Passport: Do you have a passport? Check it. Is it expired or will it expire while you’re
away? Be sure to start the passport application process early! Attach a copy of the
photo page of your passport to your Bennington Study Away Application.
❑ Student Information and Emergency Contact Forms: Complete the attached forms
and submit them with your application.
❑ Consortium Form: If you receive federal financial aid or other transferable funds, fill
out this form and schedule a meeting with Amy Starr in the Financial Aid Office.
❑
Medical Clearance: Visit Student Health Services for a pre-departure health screening
and to discuss your travel health planning and designation specific information.
❑
Pre-Departure Orientation: Attend this session facilitated by the Director of Learning
Beyond Bennington - held in late November and early May.
Student Information Form
Student’s Full Name: _______________________________________________________
Current term at Bennington (3
rd
, 4
th
, etc.): ______________________________________
Email (non-Bennington):______________________________Phone:_________________
Are you a U.S. Citizen: ◻ Yes ◻ No
May we release your name and email to potential study abroad participants?
◻ Yes ◻ No
Academic term away (term and year): _________________________________________
Do you receive federal financial aid?
◻ Yes ◻ No
If you are an international student, do you receive the Davis Scholarship?
◻ Yes ◻ No
Permanent (Home) Address Information:
Address: ________________________________________________________________
City: ______________________________ State: ________ Zip: ______________
Country:_________________________________________________________________
Telephone: ________________________ Email: _____________________________
I understand that in order to be approved for an exchange, students must be in Good
Academic and Disciplinary Standing and have approval from their Faculty Advisor, plan
committee, and the Study Away Counselor.
Student (signature):_______________________________________Date:_____________
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
PROPOSED COURSE OF STUDY
Name of Student: __________________________________________________________
Host Institution: ___________________________________________________________
Check each box when complete:
❑ Fill in course information about the classes you hope to take while studying away. Please
note that course availability may be limited, so be sure to include alternate course
selections. We know that your course selections may not be finalized until you’re away.
Please be sure to email your final course schedule to your Faculty Advisor and
the Study Away Counselor when you have it.
❑ Discuss your potential course selections with your Faculty Advisor and Plan committee
members.
❑ Students should plan to enroll in the equivalent of 15 Bennington College credits per
term. Since credit values can vary between institutions, students should consult with
the Study Away Counselor to confirm the total credit amount.
Course Title Department Credits
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Total Credits __________
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
DOMESTIC EXCHANGE
DECLARATION OF AGREEMENT
● Studying abroad is a privilege that is available to students who have demonstrated the
ability to adjust academically and emotionally to college, and who are ready to benefit
from the challenges of off-campus study. In order for students to receive and maintain
approval for study away, they must be in Good Academic and Disciplinary Standing and
have approval from their advisor, plan committee, and the Study Away Counselor.
● Students must enroll in the equivalent of 12 Bennington credits (minimum) to maintain
full-time student status while abroad.
● If students do not enroll in and successfully complete a full-time load of classes while
away, their academic standing may be in jeopardy when they return.
● Upon completion of your term(s) away, have an official transcript sent to the registrar
here:
Bennington College - Office of the Registrar
1 College Drive, Bennington, VT 05201
● Transfer credit will be awarded for grades of full ‘C’ or above received on an official
transcript.
● I understand that it is my responsibility to request an official transcript from my host
institution and that an official transcript must be received in order for credits to be
transferred. I understand that a provisional report can be used to verify credits earned
until an official transcript is available.
● An official transcript for work completed abroad must be received by the Office of the
Registrar no later than February 10 for students studying abroad in the fall term and no
later than August 1 for students studying away for the spring term.
● Consortium Students (students who are applying federal financial aid to the cost of their
program) understand that eligibility for financial aid cannot be determined until
verification of credits completed is received. If a transcript does not arrive by the dates
above, a student will not be eligible to receive financial aid for the coming term.
● Students studying away for a full year must arrange to have a transcript sent to
Bennington after each term/semester. If a transcript is not received verifying completion
of credits, financial aid cannot be released for the following term.
● Consortium Students must successfully complete a full-time course load with grades of C
or above. Failure to do so will impact financial aid eligibility for the coming term.
I, ________________________________ , have read and understand the above
statements.
Student’s signature ___________________________________________ Date: ________
I, _________________________________ , have read and understand the above
statements.
Parent’s signature ____________________________________________ Date: ________
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
Emergency Contact Information
______________________________________________________
I understand that in the case of an emergency, Bennington College officials may
notify my emergency contact(s).
_______________________________________ _________________________
Signature Date
Please provide your information.
Name: ____________________________________ Term Away: ___________________
Permanent Address: ________________________________________________________
Cell Phone: ___________________________ Home Phone: _______________________
Non-Bennington Email Address: _______________________________________________
Please provide complete & accurate information for all emergency contacts listed.
If this information changes at any point before or during the program, please
notify the Study Away Counselor immediately.
1
st
Emergency Contact:
_________________________________________________________________________
Relationship: _________________________________ Home Phone: ________________
Work Phone: _________________________________ Cell Phone: __________________
Address (please provide physical address, not
PO Box):
_________________________________________________________________________
_________________________________________________________________________
Email Address: ____________________________________________________________
2
nd
Emergency Contact:
_________________________________________________________________________
Relationship: _________________________________ Home Phone: ________________
Work Phone: _________________________________ Cell Phone: __________________
Address (please provide physical address, not
PO Box):
_________________________________________________________________________
_________________________________________________________________________
Email Address: _____________________________________________________________
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
DOMESTIC EXCHANGE PROGRAM APPLICATION
FACULTY RECOMMENDATION
Name of Student: ____________________________________________________
Host College: _______________________________________________________
❑ I waive my right to see this letter of recommendation.
❑ I do not waive my right to see this letter of recommendation.
Student’s Signature: _________________________________________________
To be completed by the faculty advisor or a member of the student’s Plan
Committee and returned to the Study Away Office (Barn 120C).
Instructions: Please attach a letter outlining your assessment of the candidate’s
suitability for study away. Your letter may be shared with the host institution if the
student is nominated for study away.
Check the appropriate box below:
❑ I am familiar with the student’s academic standing and believe that his/her
progress at Bennington and intellectual interests are such that he/she would
profit by participating in this exchange program.
❑ I recommend the applicant with respect to his/her character and maturity for
admission to this exchange program.
❑ I have spoken with the applicant and reviewed his/her proposed course
selection for the term away, and find it to be appropriate with respect to
his/her fields of interest and Plan of study here at Bennington.
Additional Comments (optional):
Faculty Name (please print): ___________________________________________
Faculty Signature: ______________________________________ Date: _______
Please contact the Academic Services and Study Away Counselor with any
questions (x2490 or studyaway@bennington.edu).
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
TRANSCRIPT REQUEST FORM
In order to request a transcript, please complete the following steps:
Complete, sign, and mail this Transcript Request Form to:
Office of the Registrar
Bennington College
One College Drive
Bennington, Vermont 05201
or you may fax the form to 802-440-4876.
Please note:
● Transcripts will not be issued if a financial obligation to the College exists.
● Allow two weeks from date of receipt for the request to be processed.
First name: ______________________ Middle initial: _____ Last name: _______________________
Full name while at Bennington: ________________________________________________________
Address: __________________________________________________________________________
City: ___________________________________________ State: _______ Zip: ___________
Telephone: ______________________________ Email: _______________________________
Weekdays, between 9:00am and 4:30pm
Date of attendance at Bennington: ____________________________________________________
Program of study: □ BA □ MAT □ MATSL □ MFA □ Postbacc
Transcript should be sent: Purpose of Transcript:
□ Now □ Graduate or professional school application
□ To arrive by deadline: _______ □ Employment
□ Hold for end of term grades/evaluations □ Study Abroad
□ Other instructions: __________________ □ Transfer
_____________________________________ □ Personal use
I hereby authorize the release of my transcript. Please mail #_____ transcript(s) to the address(es)
listed below. Signature: __________________________________ Date: _____________________
Request 1 Request 2
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
Request 3 Request 4
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
_________________________________________ ______________________________
Office of the Provost and Dean
Domestic Exchange Application / Updated: 07/07/2020
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STUDY AWAY APPLICATION DOMESTIC EXCHANGE (Bennington College)

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Completed 22 July 2020

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