MID-YEAR STUDENT REPORT

YOUR NAME: __________________________________ HOME COUNTRY: _____________________

HOST INSTITUTION: _________________________ GRANTEE ID: _______________________

Does your host institution operate on a SEMESTER or QUARTER system? (Circle ONE)

FALL & WINTER TERM(s): List all completed courses.

Course Title Credit or Audit? Grade Received
1.
2.
3.
Any Additional Courses or Research?

SPRING TERM: List courses you are registered to take.

Course Title Credit or Audit?
1.
2.
3.
Any Additional Courses or Research?

Which course fulfills the AMERICAN STUDIES REQUIREMENT and WHY?

ENDORSEMENT OF FLTA SUPERVISOR:

I certify that the foregoing information concerning the FLTA’s academic program is correct and that this
FLTA's performance has been satisfactory in all respects. (If unable to certify, please explain, attaching a
separate sheet.)
____________________________________ _______________________________________
Name of FLTA’s Supervisor Supervisor’s Signature
____________________________________ ________________________________________
Supervisor’s Telephone Supervisor’s E-mail Address
____________________________________ ________________________________________
FLTA’s Signature Date