Instrucciones:
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1. Incluya con su formulario $60 para su aplicación
y un depósito de $400 para la matricula (ninguno
es reembolsable). Cualquier cheque (no pueden ser cheques
personales) o cualquier orden de dinero debe hacerse
a nombre de Syracuse University.
2. Incluya en su aplicación copias
certificadas de sus récords académicos,
prueba de su aceptación a alguna universidad
norteamericana, y/o una declaración que
explique su necesidad de estudiar inglés.
3. Complete el formulario
del ELI, incluyendo la declaración bancaria.
Ud. puede imprimir el formulario o descargar
el archivo (pdf).
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4. Una vez completado el formulario debe de
ser enviado a:
Syracuse University
English Language Institute
700 University Avenue, Room 207
Syracuse, NY 13244-2530
USA
Teléfono: 315-443-2390
Fax: 315-443-1530
elimail@uc.syr.edu
www.YeSU.syr.edu/eli
5. Someta
por favor una foto de pasaporte
junto con una copia de su pasaporte.
6. Agregue $50 adicionales para
los envios del correo expreso.
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1. Check when you plan to begin studies at the Institute:
Fall ____ Spring ____ Summer I ____ Summer II _____ Summer
III _____
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 . Sex: 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
____
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_____________________________________
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 |
Fair |
Poor |
None |
| 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?
________________________________________________
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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