Please note: This form is only to be used if you are studying abroad/away with a non-CUNY program or programs with direct enrollment to the university abroad/away. A copy of your paid tuition bill from the foreign institution and proof of permit registration is required to submit this form. This from must be submitted prior to the activity. Requested Semester - Deadline Summer/Fall - July 1st Winter/Spring - January 8th If you fail to meet the deadline, reimbursement is not guaranteed. If you need any assistance with the form or having problems meeting the deadline, please contact Ms. Sasha De Silva right away by email at email@example.com or by phone at 212-729-2940. Section 1: Student InformationName* First Last EMPLID*Class year*select year201520162017201820192020Campus*select campusBaruch CollegeBrooklyn CollegeCity CollegeHunter CollegeJohn Jay CollegeLehman CollegeQueens CollegeCollege of Staten IslandAdvisor at Baruchselect your advisorMs. Stacey BackenrothMs. Chrystle-Claire GreeneMs. Elena PellegriniMs. Harmony OseiAdvisor at Brooklynselect your advisorMs. Jaime WeissMs. Sandy AlexandreMs. Georgia Southern-PennAdvisor at Cityselect your advisorDr. Irina StoyanovaDr. Kate LevinMr. William LungAdvisor at Hunterselect your advisorMr. Vasiliy ArkanovMs. Charlotte GlasserMs. Cristina GleicherMs. Joanna KataAdvisor at John JayMs. Adrienne FitzGeraldAdvisor at LehmanMs. Lena TuckAdvisor at Queensselect your advisorDr. Lorna RonaldMs. Wynter GreeneAdvisor at CSIselect your advisorMs. Lisa FrenchMs. Anita RomanoPhone*Email* Enter Email Confirm Email You may input your Macaulay email address or your preferred email address.Section 2: Program InformationSponsor/Host College*Name of International/Away Institution*You may enter "N/A" if this does not apply to your request.City, Country*You may input the State as well where applicable.Semester/Session*Please select oneSummerFallWinterSpringPlease select the semester or session you will be away or abroad. If you have requests for multiple semesters or sessions, a new form must be completed for each one.Date From* Date to* Number of Classes*Number of Credits*Indicate the number of credits to be transferred back to your CUNY home campus for reimbursement. Upload a copy of your paid tuition bill*Accepted file types: pdf, jpeg, jpg, png.This bill must be from the sponsor/host/international institution and it must be clear which charges are for tuition. Ensure that your name and the institution name are visible on the bill.Upload a copy of your permit*Accepted file types: pdf, jpeg, jpg, png.This can be a screenshot of your CUNYfirst class schedule with the study abroad class (example: STABD) highlighted. This is needed for posting awards for the semester that you are requesting.External Links to Non CUNY Permit Information for Your Campus(These links open in a new tab) Baruch College Brooklyn College City College College of Staten Island Hunter College John Jay College Lehman College Queens College Section 3: Statement of AcknowledgementYou must read and check off all statements listed below to be eligible for the study abroad tuition reimbursement.* I acknowledge that I must submit a paid (zero balance) tuition bill from the foreign institution to be eligible for the reimbursement. I acknowledge that I will be reimbursed at the CUNY in-state tuition rate and according to the semester tuition policy. I acknowledge that my reimbursement will be reduced by any tuition-only scholarships or grants received. I acknowledge that to be reimbursed I must receive passing grades in all courses completed abroad. I acknowledge that before I can be reimbursed I must register for a permit at CUNY, officially transfer all courses taken abroad to CUNY and they must appear on my CUNY transcript. I acknowledge that I must complete my FAFSA and TAP for the academic year requesting reimbursement. I acknowledge that my reimbursement will be issued as funds become available and can take a year or more to process. Signature*Please enter your initials to sign this form. The submit button appears once you have completed the form.