Student ID#: First Name:  Last Name: 

UCI E-mail Address:

Country where you will be studying: 

IOP Program (Ex: International Studies Abroad; Semester at Sea, etc.):

IOP Program Website URL:

Institution issuing final transcript (Ex: Universitat Autònoma de Barcelona; Bond University, etc.):
NOTE: If you do not know which institution is issuing your transcript, don't guess.  If you do not know, ask your IOP Program NOW.

Website URL indicating information on Institution issuing final transcript:

Term (Ex: Year 2013-14; Fall 2013; etc.):

I want to receive units on my UCI transcript for the courses I plan to take on my IOP program: Yes No

I want to fulfill degree requirements (major, minor, and/or GE) with courses I plan to take on my IOP program: Yes No

I am planning to take a language class abroad in a language of which I am a native speaker or have previously taken high school or college level classes: Yes No

I want to receive financial aid for my IOP program: Yes No
If Yes, also respond to all three of the bulleted questions below:

• I have met with Scott Brandos in the UCI Financial Aid Office to discuss my financial aid eligibility: Yes No
• Number of weeks of my IOP program. (Don't guess.  If you do not know, ask your IOP Program NOW):
  
• Number of units I plan to complete on my IOP Credit Contract: These are Semester or Quarter units.

If you have any specific questions or concerns, you can include them in the space below: