1. Name (as it appears on your passport): Family name: ______________________________________________ Given Name: ______________________________________________
2. Mailing Address:
3. I am accepted for the Fall semester at the University at Albany as a Graduate student in the following department:
Department: ________________________________
4. University at Albany ID number: ___________________________ (From your University at Albany acceptance letter.)
5. Gender: Male Female
6. Country of Birth: ____________________________ 7. Country of Citizenship: ____________________________
8. Date of Birth: Month: ________________ Day: ______ Year: ______
Please complete this SAI Application Form and return it by email, express mail, or fax. The non refundable $80 Application Fee should be in the form of a money order or bank check made out to the University at Albany. (If your application form is faxed or emailed, the $80 application fee will be added to your UAlbany bill.)
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
