1. Name (as it appears on your passport): Family name: ______________________________________________ Given Name: ______________________________________________
2. Mailing Address:
3. Please check ONE box. I am accepted for Fall 2008 at the University at Albany as a(an)
Undergraduate student
Graduate student in the following department: ________________________________
4. SEVIS ID number: ____________________________ (begins with "N" followed by 10 numbers) OR Check if you have not received your I-20 from the University.
5. F-1 visa holders only: Will you be bringing F-2 dependents (spouse, children) for this summer session? Yes No
6. Dorm: On-campus housing is available for the 8-week summer course. Do you plan to live in the dormitory for the summer? Yes No
7. University at Albany ID number: ___________________________ (From your University at Albany acceptance letter.)
8. Gender: Male Female
9. Country of Birth: ____________________________ 10. Country of Citizenship: ____________________________
11. Date of Birth: Month: ________________ Day: ______ Year: ______
Please complete and print this application form and return it by express mail or fax. (If faxed, please mail the S.A.I. application fee by express mail as soon as possible.) The application fee should be in the form of a money order or bank check made out to the University at Albany .
Summer Academic Institute Address:
Director - Intensive English Language Program University at Albany, SUNY Science Library G14 1400 Washington Ave Albany, New York 12222 U.S.A. Telephone: (518) 437-5040 FAX: (518) 591-8171 E-mail: ielp@albany.edu
