Exchange - OSAP Supplemental Information Form, Official York ...

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Student Financial Services

Exchange – OSAP Supplemental Information Form Official York University Academic Exchange Participants (York International)

A04

Notes: • • •

You are responsible to report any scholarships or awards on your OSAP Application Form. Student Financial Services will be informed of your York International Mobility Award (YIMA). Please do not enter it onto your OSAP application. If you are going on exchange to a country in the Southern Hemisphere for their full academic year (beginning in the winter of 2015), you will need to fill out this form twice – when you are applying for the 2014-2015 OSAP and the 2015-2016 OSAP.

Student Information (please print) Last Name/Family Name (Mr/Ms/Miss)

Given Name(s)

Student Number

Social Insurance Number

Faculty

 AP

 ED

 ES

 FA

 GS

 HH

 SC

Keep your information up-to-date! Make sure we have your current contact information. Visit My Personal Info on the My Student Records section of the Current Students Web site at http://www.registrar.yorku.ca/myonlineservices/

Exchange Program Information – Official University Academic Exchange Name of Host Institution (e.g. University of Copenhagen)

Country of Host Institution (e.g. Denmark)

Term(s) Away on Exchange (choose one)

Summer 2014

Fall/Winter 2014-2015

Student’s Signature

Fall 2014

Winter 2015

Date (dd/mm/yy)

The information in the box below must be completed by an official at York International. York International will submit this form to Student Financial Services. Office Use Only Start and End Dates of Host Institute Semesters (dd/mm/yy): Semester 1 Dates (dd/mm/yy) From _______________________ to _______________________ Exam Dates Semester 1 (dd/mm/yy)

Semester 2 Dates (dd/mm/yy) From _______________________to _______________________ Exam Dates Semester 2 (dd/mm/yy)

From _______________________ to _______________________ Holidays Semester 1 (dd/mm/yy)

From _______________________ to _______________________ Holidays Semester 2 (dd/mm/yy)

From _______________________ to _______________________

From _______________________ to _______________________

Number of Mandatory Weeks of the Program*: _________________________________________ *Should state the number of mandatory weeks of the program (classes + exams), i.e. 26 weeks of classes + 4 weeks of exams = 30 weeks • Undergraduate students on a York University-Wide Academic Exchange are required to take a full course load = 100% • Graduate = course load is always 100%

Exchange Program Coordinator, International Mobility Programs Signature __________________________________ Date (dd/mm/yy) ________________________ Protection of Privacy: Personal information in connection with this form is collected under the authority of The York University Act, 1965 for educational, administrative and statistical purposes. The information will be used to process your enrolment and registration in academic programs; to record and track your academic progress; and for related record-keeping purposes. If you have any questions about the collection, use or disclosure of this information by York University, please contact the Manager, Student Client Services, W120 Bennett Centre for Student Services, York University, 4700 Keele Street, Toronto ON, M3J 1P3, 416-872-9675. Exchange – OSAP Supplemental Information Form, Official York University Academic Exchange Participants (York International), May 2014