Instructions |
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1) Include an application fee of $60 (nonrefundable) and
a tuition deposit of $400 (nonrefundable). Make checks (no
personal checks) or money order payable to Syracuse University.
2) Include photostatic or certified copies of academic records
OR proof of acceptance at an American university,
OR a statement documenting the need to study
English.
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3) Complete this application, including the
financial statement on the back, and include a bank statement.
4) Send to:
Syracuse University
English Language Institute
700 University Avenue
Room 207
Syracuse, NY 13244-2530
USA
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5) Submit a passport photo along with a copy
of your passport.
6) Add an additional $50 for express mail shipments. |
You may either print this page, or download a pdf
of the application form.
1. Check when you plan to begin studies at the Institute:
Fall ____ Spring ____ Summer I ____ Summer II _____
Short-Term __________ (Dates: from ______________to_____________)
2. Name___________________________________________________________________
family
name first middle maiden
(married woman)
3. Address__________________________________________________________________
street
number and name apartment
number
___________________________________________________________________________
city state/province country zip
or postal code
4. Home Phone: ___________________ Fax (if available) _______________________
Work Phone: ______________________ Fax (if
available) _______________________
E-mail Address: _________________________________________________________
5. Mail admission materials via: Regular mail ________ Express
mail ________
(The student will be charged for express mailing.)
6. Syracuse area telephone contact ____________________________________
7. Gender: Male:_____ Female: _____
8. Date of birth _____________________________________
month day year
9. Country of birth ___________ Country of citizenship ______________
10. Single ____ Married ____
Will your spouse accompany you? Yes ____ No
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If yes, please provide:
Spouse's Name__________________________________________
Date of Birth______________________________
Country of Citizenship______________________________
Country of Birth____________________________________
11. Will children accompany you? Yes
____ No ____
If yes, please provide:
Child's Name_________________________Gender: Male:____Female:____
Date of Birth______________________________
Country of Citizenship______________________________
Country of Birth____________________________________
12. Do you desire on-campus housing? Yes
____ No ____
single ____ double ____ 2-bedroom apartment _____
Please complete separate housing application.
13. Are you applying for a student visa with this application? Yes
____ No ____
14. If currently in the United States, what type of visa do you hold?
Student _____ Exchange _____ Visitor
_____ Tourist ____ Other_____________
15. Education (highest level completed-secondary or university) _________________
16. Language(s) spoken ______________________________________________
17. Are you enrolled in another American Institution? No
____ Yes (name)____________
18. Have you studied English at another institution? No _____ Yes
(name)____________
19. Have you taken the Test of English as a Foreign Language?
No ____ Yes_____ Date ____________ Score _________
20. What do you plan to do after completing intensive English studies?
_______________________________________________________________________
21. Major field of study: Undergraduate ________________________________________
__________________ Graduate _______________________
22. Profession ___________________________________________________________
23. Please indicate your knowledge of English with a check mark:
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Good
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Fair
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Poor
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None
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Speaking
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Understanding
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Reading
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Writing
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24. How did you hear about the ELI at Syracuse University?
referral____internet search____advertisement____SU website____other_______________
25. Financial Statement (certified bank statement must
be included):
a. Name and address of parent, guardian, or
sponsor(ing agency) (unless self-supporting)
_____________________________________________________________________
b. Signature of parent, guardian, or sponsor (unless
self-supporting)
____________________________________________________________________
c. This is to certify that I am aware of the costs
for the English Language Institute at Syracuse University. I have
funds available as required. I also understand that tuition is
not refundable after the first day of the semester.
Signature of applicant_______________________________________ Date____________
Health Insurance is mandatory and can be purchased at the
English Language Institute.
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