The University of North Carolina at Chapel Hill: Exchange Nomination

Nomination Form: International Exchange Programs at The University of North Carolina at Chapel Hill

This form should be completed by the school officer / faculty member who is authorized to provide nominations for participation in foreign exchange programs by students outside the United States at The University of North Carolina at Chapel Hill. After this nomination is received, the student will be invited to complete an application.

If you have more than one (1) student to nominate, this form must be completed separately for each nominee.

Nominator's Information

First Name

Last Name

Email Address

Duration of Study

Study Plan

First term in which the student is attending

Year in which the student will begin studies

Institution and Program Information

UNC School or Academic Program

Continent / Region

Country

Name of Country

Institution

Name of Institution

Student is attending under UNC-COWA

Please select the appropriate UNC department

Student / Nominee Information

Student First / Given Name(s)

Middle Name(s)

Student Last / Family Name(s)

Student's Birthdate

Student's Email Address

Student / Nominee Academic Information

Grade Point Average (GPA) (U.S. 4.0 scale)

Academic Department / Field of Study at home institution

Please select the student's academic level

Is the student in good academic standing to the best of your knowledge?

Yes

No

To the best of your knowledge, does the student have any outstanding disciplinary violation(s) or pending civil / criminal charges?

Yes

No

Please provide further explanation below