Academic Services Clearance Form

Academic Services Clearance Form

All GU students applying to study abroad in any program(s) must receive clearance from the GU Academic Services office.

Please complete the electronic form below. The information you provide will be directly submitted to the GU Academic Services office for clearance. The Academic Services office will answer the questions below and provide results to the GU Study Abroad office.

  1. Is this student a matriculated undergraduate?
  2. Is this student in good academic standing?
  3. Has this student ever been on academic probation?
  4. Has this student ever been found in violation of the academic honesty policy?
  5. Has this student ever been on academic honor probation or suspension?
  6. Is Academic Services aware of any concerns regarding social, behavioral or academic issues that might impact this student's ability to study abroad successfully?
  7. Does this student have your approval to study abroad?
  8. Please add any additional comments you might care to make concerning this student's eligibility and/or qualifications for studying abroad, or for any clearance changes.
Do Not Edit:
Do Not Edit:
Do Not Edit:

Student Personal Information
GU ID Number
First Name:
Middle Name:
Last Name:
Cell Phone Number:
Your Email Address:
Your Current Class Status: Freshman Sophomore Junior Senior

Program Information

Name of First Program:
Location of Program
Term Applying To:
Spring 2010 Summer 2010
Academic Year 2010/2011 Fall 2010 Spring 2011
Name of Second Program:
Location of Program
Term Applying To:
Spring 2010 Summer 2010
Academic Year 2010/2011 Fall 2010 Spring 2011
Name of Third Program:
Location of Program
Term Applying To:
Spring 2010 Summer 2010
Academic Year 2010/2011 Fall 2010 Spring 2011

Authorization To Release Information
Yes, I hereby waive my right to access information on this form and request that it be completed and forwarded to the GU Study Abroad office.

Acknowledgement
By typing my name and date below, I acknowledge that even after Academic Services clears me, any academic concerns prior to departure may place my participation in the requested program(s) at risk and may incur financial consequences.
Your full name:    Date (MM/DD/YEAR):