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ACADEMIC STUDY
ABROAD PROGRAM: |
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Short-Term Study
Abroad Program:
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For Short-Term:
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PERSONAL
INFORMATION: |
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Salutation
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Last Name
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First Name,
Middle Initial
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<< Your Name as it Appears
on Your Passport >> |
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Student ID
Number
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Date of Birth
-- |
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Country of
Citizenship
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Country of
Birth
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Immigration
Status
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If other,
please explain
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Foreign
Language(s) Spoken
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ACADEMIC
INFORMATION: |
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Academic Major
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Matriculated
Yes
No |
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Current
Semester
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Status:
Full-time
Part-time
N/A
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For Applicants
Not Currently Enrolled at FIT |
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University/College Currently Attending |
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Major at
University/College |
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CURRENT
ADDRESS: |
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Street Address
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Apartment
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City
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(Province)
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State
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ZIP / Postal Code
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Country
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Home Phone
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Cell Phone
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(If Applicable)
Move out date for above address:
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School [FIT] Email Address
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Personal Email Address
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PERMANENT
ADDRESS: |
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Same as
current address
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Street Address
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Apartment
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City
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Province
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State
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ZIP / Postal Code
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Country
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Home Phone
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Cell Phone
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EMERGENCY
CONTACT INFORMATION: |
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Name |
Relationship
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Address
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Phone |
Email
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QUESTIONS OR
COMMENTS: |
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Please include any questions or comments about the program or the application procedure. |
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I UNDERSTAND
THE FOLLOWING: |
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I am responsible for providing appropriate visas to any country visited and US reentry
documents, if required.
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As an FIT student enrolled in a study abroad course, I am subject to all rules and
requirements as to conduct and scholarship as specified in the FIT student handbook.
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If I am asked to leave the program because of conduct or scholarship infractions I
am not entitled to any refunds.
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I understand the payment and refund policy as described on the International Programs web
site.
I have read and understand the above
statements.
Initial here: |
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Please be sure all
information is accurate and complete before
clicking submit. |
