INTERNATIONAL EXCHANGE CONTRACT
In consideration of the University of Victoria (hereinafter called “UVic”) permitting me to
enroll and participate in the International Exchange Program (hereinafter called the
“Program”) and by initialing where indicated and placing my signature at the end of this
contract, I,___________________________ hereby:
1. AGREE, upon being notified of acceptance into the Program, to immediately
pay the $150 non-refundable administration fee to “University of Victoria”.
2. AGREE to pay all of my expenses associated with my participation in the
Program including but not restricted to the payment of:
(a) tuition and fees payable to UVic as specified below:
i) fees for a one academic year exchange are for 15 units of tuition (7.5
units for a one academic term exchange), irrespective of the number of
units of UVic credit that are earned while on the exchange, plus the UVic
Students’ Society fee, the Athletic and Recreation fee, other student
society fees (as indicated in UVic Calendar) and U-Pass bus pass fee. I
understand that once the Program has commenced, these tuition fees are
ii) all fees will be at the rate being charged by UVic in the academic session
in which the exchange commences, such fees being due and payable to
the University of Victoria on the regularly-scheduled tuition fee deadlines,
iii) the UVic Students’ Society Health Plan premium will also be levied unless
I opt out of it within the time frame permitted by the UVic Students’
(b) the cost of text books and educational supplies required for the Program
at the host institution,
(c) all travel, medical/health insurance, accommodation and living expenses
associated with my participation in the Program, and
(d) all medical and pharmaceutical expenses incurred for my benefit, and
(e) all personal travel that I may undertake.
3. AGREE and certify that I either:
(a) have the funds required to pay all of the expenses referred to in
Paragraph 2, or
(b) have a commitment from another person or financial institution to provide
the funds required to pay all of the expenses referred to in Paragraph 2.
4. UNDERSTAND that it is my responsibility to:
(a) discuss the necessity of a student loan with a UVic Financial Aid
Officer if required,
(b) make arrangements to pick up any student loan received, and
(c) make arrangements for a Power of Attorney to pick up a student loan in
my absence if necessary.
5. ACKNOWLEDGE that there is no obligation or commitment by UVic to provide
any funds to assist with the payment of any of the expenses referred to in
Page 1 of 5
Paragraphs 2 and 4 of this document unless such a commitment is in writing,
addressed to me and signed by an appropriate official of UVic.
6. ACKNOWLEDGE that I am in a satisfactory state of health to participate in the
Program and AGREE that prior to departure I will obtain any vaccinations or
inoculations that are recommended or required by the government of a foreign
country in which I will be travelling or by the Canadian Government for persons
entering Canada from a foreign country.
7. AGREE that I have or will obtain insurance that will provide me with medical and
health coverage for the duration of my participation in the Program including
appropriate coverage for any independent travel I may undertake while on the
8. UNDERSTAND that it is my responsibility to:
(a) opt out of the UVSS Extended Health Insurance if I am eligible to opt out,
(b) obtain additional health insurance to satisfy UVSS requirements if I opt
out of their plan,
(c) ensure that my coverage includes travel to and from the exchange site.
9. AGREE that I am responsible for obtaining any visa or permits that may be
necessary with regard to my travel to foreign countries while participating in the
Program and renewing or extending my visa or residency permit prior to its expiry
date for the duration of my participation in the Program.
10. AGREE that I am responsible for making all arrangement for my accommodation
during the period of my participation in the Program, notwithstanding that UVic or
the host institution may provide information to me with regard to
accommodations. UVic does not warrant the quality or safety of any
accommodation and UVic is not responsible for acts or omissions of the
operators of any accommodation.
11. CONSENT to the disclosure by the host institution of my progress reports and/or
official transcripts and any other pertinent information about my conduct while on
the Program, including, but not limited to information about my academic
performance, academic record or disciplinary records as may be requested by
UVic to UVic on an interim and final basis as required. I will request the host
institution to forward my official transcript to UVic Undergraduate Admissions and
Records upon completion of my exchange studies.
12. UNDERSTAND that:
(a) I may not be able to take the courses I initially select at the host
institution for reasons beyond the control of UVic, and further understand
that I may not receive UVic credit for all the courses I take at the host
(b) in order to expedite the exchange study evaluation by UVic, I will submit
my registration summary together with course outlines, contact hours per
course, and grading information to Undergraduate Admissions and
Records, as requested by them, upon completion of my exchange,
Page 2 of 5
(c) a notarized translation of documents issued in a language other than
English will be required for all but language courses, and
(d) the determination of course equivalencies cannot proceed until the
above-noted official transcript and documentation is received; evaluation
of exchange credit will be processed in the order in which it is received.
13. UNDERSTAND that the grades of all courses taken at the host institution will not
be recorded on my UVic transcript and only UVic credit will be noted, with the
exception of a failing grade which will be recorded on my UVic transcript and
calculated into my GPA.
14. CONSENT to the disclosure by UVic during the period of my participation in the
Program of any personal information that is currently in the possession of the
University or that may come into the possession of the University, other than the
record of my academic performance, in any or all of the following circumstances:
(a) to a hospital, supervising medical personnel, provider of medical
treatment or next of kin where the University is informed that I may
require medical attention or treatment,
(b) to an official of a Canadian Consulate or the Canadian Government, the
Consulate of a foreign country in which I plan to travel, an airline on which
I am booked as a passenger, or an agency that is responsible for my
travel arrangements where the University is informed that the information
is required to satisfy the immigration or visa requirements of any country
in which I am traveling or plan to travel, or to facilitate my travel in
conjunction with the Program,
(c) to a financial institution, financial agency or next of kin where the
University is informed that I require funds for the purpose of travel,
accommodation or other purposes related to the Program,
(d) to law enforcement authorities where the University is informed that the
information is required to assist me, or
(e) as permitted under the Freedom of Information and Protection of Privacy
Act of BC.
UVic collects the personal information referred to above pursuant to the
University Act, section 26(c) of the Freedom of Information and Protection of
Privacy Act, and UVic policies and procedures. The information is collected by
UVic for the purpose of the administration and operation of the Program. Should
you have any questions about the collection, contact the administrator of the
International Exchange Program.
15. AGREE, barring an emergency situation, to complete the full length of my
participation in the Program. If an emergency situation makes it imperative for
me to withdraw from the Program, I understand that I must inform both the host
institution’s and UVic’s exchange advisors of my situation IMMEDIATELY.
16. UNDERSTAND that I must contact the UVic advisor and the host institution
coordinator in the event of any emergency situation which interferes with the
successful continuation and/or completion of my exchange program.
Page 3 of 5
17. ACKNOWLEDGE that due to the international aspect of the Program,
circumstances beyond the control of UVic may arise including war, civil unrest, or
natural disasters that may require a modification or termination of my position in
18. COMMIT to being an honourable representative and ambassador of UVic and to
conduct myself in a manner that will not offend either the laws of the host country
or the cultural norms or behavior patterns of the people of the host country. I
ACKNOWLEDGE AND AGREE that UVic reserves the right to terminate my
enrollment and participation in the Program if I fail to maintain an acceptable
standard of public and private conduct during my participation in the Program.
19. AGREE upon my return from the Program to assist the International and
Exchange Student Services in some or all of the following ways:
update information regarding the partner universities and activities,
assist with the preparation of students who will participate in the Program in
assist with the provision of educational services to exchange students coming
participate in orientation activities for international exchange students,
complete a returning Exchange Student Report.
20. AGREE that I while participating in the Program I am subject to the rules and
requirements of both UVic and the relevant host institution.
21. UNDERSTAND that I am responsible for pursuing and completing all
arrangements with respect to my exchange including but not limited to the
admission to the host university,
residence/living arrangements for the exchange,
selection and submission of course choices to the host university,
travel, immigration (visa or permits) and medical/health insurance
enrolment in courses for my return to UVic, and
attend the Pre-Departure Orientation.
22. This Agreement and the Release of Liability, Waiver of Claims, Assumption of
Risks and Indemnity Agreement International Exchange Program are the entire
agreement between UVic and me with respect to its subject matter. This
Agreement cannot be delegated or assigned by me, and shall enure to the benefit
of and be binding upon the successors and the permitted assigns of UVic. No
variation, modification or termination of this Agreement and no waiver of its
provisions or conditions shall be valid unless in writing and signed by a duly
authorized signatory for UVic and by me. This agreement may be signed by
facsimile and in separate counterparts each of which when so executed and
delivered shall be an original, but all such counterparts shall together constitute
Page 4 of 5
one instrument. The headings and section numbers in this Agreement are included
for convenience of reference only and shall not affect its interpretation or meaning.
23. ACKNOWLEDGE that I have read and understand this document.
Name (please print): ________________________________
This contract must be completed in full, signed, dated and initialed where indicated on
preceding pages before the Participant may begin the International Exchange Program.
To secure your International Exchange placement, you must sign and return this form,
your “Release of Liability,Waiver of Claims, Assumption of Risks and Indemnity
Agreement” form, and your completed Student Emergency Information form and submit
them with your $150 administration fee made payable to “University of Victoria” either in
person at your advisory meeting, or to the International and Exchange Student Services
Office in Room A205, University Centre, or by mail to: International and Exchange
Student Services, University of Victoria, PO Box 3025, Victoria, BC, Canada, V8W 3P2.
Page 5 of 5