UH-SYSTEM CONSORTIUM AGREEMENT AMONG UH UNIVERSITIES/TEACHING CENTERS
(THIS FORM MUST BE SIGNED BY YOUR ACADEMIC ADVISOR BEFORE SUBMITTING)
Consortium Agreement Submission Deadlines: Fall – November 15, 2016 | Spring – February 26, 2017 | Summer – July 1, 2017
(CHECK THE TWO PARTICIPATING SCHOOLS, Complete a separate form for multiple schools (only those listed) and
one for each semester of co-enrollment
)
(Home School) Degree Granting School: UH-MAIN UH-DOWNTOWN UH-CLEARLAKE UH-VICTORIA
(Host School) Consortium School: UH-MAIN UH-DOWNTOWN UH-CLEARLAKE UH-VICTORIA
The two schools checked above are herein entering into a consortium agreement for:
NOTE: This form must be completed for each term you co-enroll and must be accompanied by a paid fee
receipt indicating the courses being taken at the participating consortium partner in order to be
processed so that you may receive financial aid.
Indicate the semester in which you are using this form: Fall 2016
Spring 2017
Summer 2017
Dates of Summer Enrollment _________________________________ YOUR MAJOR: ______________________
1. Take courses at the Host School that are transferable to their degree or certificate program at the Home School or be
enrolled in a remedial course(s) that increases the student’s ability to pursue his/her program of study.
2. Be enrolled in a degree-granting program at Home School and making satisfactory academic progress as specified by
their Home School Satisfactory Academic Progress policy.
3. Submit all aid forms pertinent to determining eligibility for aid awards for the appropriate academic period, including
PAID FEE RECEIPT from the participating Host Institution for the correct semester in which the Consortium Agreement
is being requested. Failure to furnish the paid fee receipt will cause a readjustment in your hours and financial aid.
4. Submit this form and your PAID FEE RECEIPT to Home School.
5. CANNOT be receiving financial aid at the Host School.
6. Make independent arrangements for payment of enrollment expenses at the Host Institution without reliance on
emergency student loans or other forms of financial assistance from Home School (Financial aid cannot be disbursed
until actual enrollment at Home and enrollment at Host Institution is verified). Home School does not pay your tuition at
the Host School. It is the student’s responsibility to take disbursed refunds and pay tuition at Host School.
SECTION I – STUDENT CRITERIA & INSTRUCTIONS
Student: Please list below the course(s) you are taking at the
Host School that are applicable to your program at Home School.
These courses must correspond exactly with those listed on
your paid fee receipt from the consortium partner. NOTE: A
new form must be submitted should your courses change.
To Be Filled Out By STUDENT
Course Hours Course Description
The above named student has permission to study at the above
campus for the “enrollment period” stated. As indicated, his/her
satisfactorily completed course credits will be transferred back to
the home school.. Note remedial courses taken, which have been
designed to increase the student’s ability to pursue his/her
program of study, will be included.
ADMINISTRATIVE USE
Transferable toward Remedial Not Necessary
Degree Plan for Degree Plan
Home School ADVISOR’S SIGNATURE
SECTION II- List Classes Taken at Host School Section Below Completed by HOME Academic Advisor
By signing this Consortium Agreement you agree to allow the Host Institution indicated above to provide the Home School’s
Office of Admissions and Records with an Academic Transcript at the end of each semester for which this Agreement is
submitted. Also with your signature you agree to the terms and requirements set forth in Section 1, Student Criteria and
Instructions.
SIGNATURE: ________________________________________________________ DATE: _____________________________
