OUTBOUND STUDENT EXCHANGE AND INTER-CAMPUS MOBILITY APPLICATION

– Step 1 of 6

To be considered for participation in the USP student exchange or inter-campus mobility programme, all applicants must complete this application form and submit it to the USP International Office. For full information about the programme, including eligibility and details of the application process, visit: https://www.usp.ac.fj/study-at-usp/international-students/exchange-programme/

Select the programme you are applying: *

USP Exchange Programme
Inter-Campus Mobility Programme

USP Exchange Programmes

Please specify the programme to which you are applying

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Year *

Semester *

Semester Two

Preferred Host University:
Please rank your top 3 choices, 1 being most preferred.

Macquarie University, Sydney, Australia

University of Wollongong, Wollongong, Australia

Victoria University, Melbourne, Australia

Deakin University, Melbourne, Australia

James Cook University, Townsville, Australia

University of South Australia, Adelaide, Australia

(Placements are not available to these universities)

Victoria University, Wellington, New Zealand
Simon Fraser University, Vancouver, Canada
University of Guelph, Ontario, Canada
University of Laval, Québec, Canada
University of Hawaii, Manoa, Hawaii
ISEP Exchange
Hansung University, Seoul, South Korea
Sophia University, Tokyo, Japan
Sonoda Women’s University, Amagasaki, Japan (2 weeks of Cultural Exchange programme in December)

Inter-Campus Mobility

Campuses open for placement

Please rank your top 3 choices, 1 being most preferred

Vanuatu

Solomon Islands

Samoa

Marshall Islands

Personal Details

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USP ID NUMBER *

Name *

CITIZENSHIP

Nationality *

Passport Number

Passport expiry date

*If you are a regional student, please submit a copy of your passport page & study permit with your Exchange application*

CURRENT ADDRESS

Street Address

Town/City

Postcode

Country *

CONTACT DETAILS

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Email *

Cellphone

EMERGENCY CONTACT

Please provide at least 2 names of the person you would like us to contact in an emergency.

EMERGENCY CONTACT

Name

Relationship

Phone

EMERGENCY CONTACT 2

Name

Relationship

Phone

Programme Of Study

USP DEGREE FOR WHICH YOU ARE ENROLLED

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Degree

Major(s)

Minor(s)

Current year of study (e.g. ‘second’)

Campus

Graduating Year

Are you

Private
Sponsored
Student

If sponsored, then provide Sponsor name:

Referees

List the names of two people who have agreed to act as referees. The referees should send their references directly to the International Office.

REFEREE ONE (ACADEMIC)

Referees

Name

Association with you

Phone

REFEREE TWO (PERSONAL)

Referees (copy)

Name

Association with you

Phone

Additional Information

GOOD CHARACTER

Students who participate in the student exchange programme are regarded as ambassadors for USP and for Fiji while studying overseas. Exchange students must be of good character. Please answer the following questions honestly.

Have you ever been convicted of a crime in Fiji or any other country, or are there any charges pending against you? *

If you answered ‘Yes’, please provide details.

Click or drag files to this area to upload. You can upload up to 5 files.

DISABILITIES

Do you have any disability, impairment, long-term injury, chronic medical condition or special learning needs?

If so, please attach a statement about any equipment or support needs you may have. Please note that this information will not affect the outcome of your application but enables us to ensure that any special needs can be accommodated at your host university.

DISABILITIES – Upload Documents

Click or drag files to this area to upload. You can upload up to 5 files.

Health Insurance

Health insurance is required for students accepted for USP Exchange. USP ensures that all students travelling on University business are covered by USP Insurance. USP will purchase overseas health insurance for all Exchange students at the host universities prior to their departure and provide with USP travel insurance to those traveling under intern-campus mobility programme.

Agreement and Waiver

I consent to:
The disclosure of personal information I have provided on this form to staff within the University for the purpose of assessing my application.
The Student Exchange Selection Committee or their nominees obtaining any personal information about me- including my academic record- which is required for the purpose of this application.

I agree to promptly notify the Student Exchange Selection Committee of any changes to the information provided on this application form.
I declare that the information I have provided is true and correct, and I have not withheld any information that may have a bearing on this application.

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Signature *

Clear Signature

Date *

Checklist:

USP Exchange Programme

With this application form, you must submit following documents for a complete application.

Exchange Unique Personal Statement
Exchange cross credit form (ONLY to be submitted by students applying for USP Exchange programme)
Exchange Academic reference
Exchange Personal reference

Inter-Campus Mobility Programme

*Students applying for INTER-CAMPUS MOBILITY placement, you will register for your courses as normal at Laucala campus and International Office will facilitate your ‘Transfer of Campus’.

ICM Unique Personal Statement
ICM Course Selection Sheet
ICM Academic reference
ICM Personal reference

If selected, you will also have to submit application for

Transfer of Campus
Change of Exam Site

Note: incomplete application/information will not be considered.

Deadline for application: Thursday, 30th March 2023