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RIT will admit and hire men and women; veterans; persons with disabilities; and individuals of any race, creed, religion,color,
national or ethnic origin, sexual orientation, age, or marital status in compliance with all appropriate legislation. |
| Family Name |
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| Given Name |
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| Home Address |
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| Are you currently in the U.S.? |
Yes No |
| What kind of visa do you have? |
F-1 B J |
| Date of Birth |
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| Country of Birth |
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| City of Birth |
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| TOEFL (optional) |
ScoreDate Taken |
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| Home Phone Number |
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| Cell Phone Number |
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| Email Address |
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Student's Signature
Sign here before submitting the form |
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| Indicate your knowledge of English |
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| Speaking |
Good
Fair
Poor
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| Reading |
Good
Fair
Poor
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| Writing |
Good
Fair
Poor
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| I am interested in applying for |
Fall (14 weeks)
Spring (14 weeks)
Summer (9 weeks)
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| I will need a dormitory room |
Yes No |
| If yes: |
I smoke I don't smoke |
| Primary contact (friend/family) in the U.S. |
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| Name |
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| Address |
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| Address Line 2 |
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| Telephone |
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My family is coming with me; I would like an RIT apartment |
| Fees: |
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| * Required |
$100 non-refundable application fee by check or money order in U.S. funds (required) |
| Optional |
$42 for express mail |
| Optional |
$100 for airport pickup. Please pick me up at the airport. I have enclosed $100 for this service. I will tell you when my flight will arrive in Rochester. |
| Optional |
$200 to pre-pay the U.S. government-required SEVIS fee and send the receipt to you. |
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You may send one check for all expenses. |
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We cannot process your application for the I-20 form until we receive the original signed application and sponsor forms, all supporting documents and a check for the required fees. |
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Send originals, supporting documents and required fees by mail to the English Language Center. |
© Student Learning Support & Assessment
