Please enter the date in the format MM/DD/YY
Please describe any special needs or services you will require during your exchange (i.e. medical treatments, medications, allergies, dietary considerations, learning aids, or facilities with handicapped access). If none, please enter none.
enter city, state, and zip
Enter your initials. I authorize the USU Office of Study Abroad to release my application and other information about my participation in this program to cooperating institution(s, program officials, and USU Financial Aid Office or other relevant USU departments.):
Enter Your Initials. I have read and agree to the Rights and Responsibilities on the following page: https://studyabroad.web.usu.edu/htm/outgoing-students/rights-and-responsibilities.