Communications and External Relations
Level 1, Student Union Building
University of Waikato
Private Bag 3105, Hamilton
Tel: +64 7 838 4007
Fax: +64 7 858 4504
www.waikato.ac.nz/international/
[email protected]
STUDENT EXCHANGE APPLICATION
Submission Deadline: 15 July – ‘A’ semester exchange; 15 January – ‘B’ semester exchange
This application should be submitted ASAP and well in advance of the stated deadlines. Submission of this application does not guarantee
acceptance. A separate host university enrolment application will still be required at a later stage.
I have a minimum ‘B’ grade average
I will have completed two semesters of study at Waikato prior to my exchange
I will be able to meet the financial costs associated with an international exchange
Please print legibly in upper-case lettering using blue ink only
PERSONAL DETAILS
Family name:
Given names:
Student ID:Date of birth:
CONTACT DETAILS
For all correspondence relating to this application (this will usually be the address that you reside at in Hamilton)
Street number and name:
Town/City:
University email:Telephone: (
)
Permanent email:Mobile phone: (
)
It is extremely important that we are able to contact you by email both before departure and while overseas. Please keep us updated.
EMERGENCY CONTACT
Name:Telephone: (
)
Address:
Email:Relationship to you:
ACADEMIC DETAILS
Three choices of university are required. Please also indicate a comparative preference level you have for each university in a scale from 1 to 5,
with 5 having the highest comparative preference level.
First choice:
Comparative preference level:
Second choice:
Comparative preference level:
Third choice:
Comparative preference level:
Note: Applications without three choices will be rejected. No guarantee can be made that your preference level will be taken into consideration.
Proposed Waikato semester(s) of study at host university (e.g. 14A, 14B etc):
Degree in which you are presently enrolled at Waikato:
Field of specialisation/major:
PLEASE TURN OVER
For more information phone 07 838 4007 or visit waikato.ac.nz/international
FINANCIALS
Will you receive or do you intend to apply for any scholarships for your exchange?
If yes, please specify:
Yes
No
Will you apply for a StudyLink student loan for exchange tuition fees and/or living cost payments?
Yes
No
Will you apply for a StudyLink student allowance for the period of your exchange?
Yes
No
TWO REFEREES
Name:Telephone: (
)
Relationship to you:Email:
Name:Telephone: (
)
Relationship to you:Email:
STATEMENT
Please attach a minimum 350 word statement (typed, double-line-spaced). The statement should reveal, in a compact way, a quality
glimpse of who you are, what you hope to achieve from exchange, your representative capabilities for the University of Waikato
and New Zealand and any other information you wish to include. This statement will also be used to assess your application for any
scholarship administered by the University of Waikato. The statement must contain your full name (typed) and be personally signed
and dated by hand at the end.
DECLARATION
I declare that the information set out in this application and on the attachments is true and correct. I declare that I have not withheld
any information that could have a bearing on my application. I understand that the Privacy Act 1993 allows the University of Waikato
to hold and use information about me in accordance with the Act. I authorise the University to collect, use and disclose personal
information provided by me, relevant to my application. I understand that my application is subject to the guidelines of the University
of Waikato Exchange Programme and that the final decision on my application rests with the host institution.
Signature:Date:
»» Incomplete applications are rejected without consideration.
»» Please ensure you have completed every part of this form and attached the required statement.
»» Two referees’ details must be fully complete.
»» Submit application promptly to:
Communications and External Relations
Level 1, Student Union Building
University of Waikato
Private Bag 3105
Hamilton
»» Allow up to 21 days for notification of an outcome.
For more information phone 07 838 4007 or visit waikato.ac.nz/international