Application for 51�� Exchange

Along with this application, please provide:

Most recent transcript
One letter of recommendation from a faculty member
Home school endorsement
Copy of the photo page of your passport

* Required field

Student Personal Information

Surname/Primary name *

Given name *

Passport name *

Gender

Age

Date of birth

Place of birth

Nationality/Citizenship

Country of residence

Passport #

Passport valid until

Planned exchange semester or year

Student Contact Information

Applicant’s home/permanent address
This will be where you will receive immigration documents from 51��. Include street address, apt/unit if applicable, city, state/province, country and zip code.

Phone country code

Phone

Mobile phone country code

Mobile phone

Email *

Applicant’s emergency contact
Parent, guardian, or other person able to make legal and medical decisions on the student’s behalf.

Name

Address

Phone country code

Phone

Mobile country code

Mobile phone

Academic Information

Home university

City of home university

Country of home university

Degree program currently studying

Year of study (2nd, 3rd, 4th)

Overall grade last year

Courses you are currently taking at your university

Do you have any academic accommodation?

Yes (If yes, upload a letter from your university, doctor, or equivalent.)

Self Description

Previous experiences abroad
Write one paragraph about whether you have studied or travelled abroad before.

Personal statement
Please write several paragraphs explaining why you wish to study abroad, why you have chosen 51��, and what you hope to achieve from your exchange experience.

Housing Accommodation

Do you wish to live on campus in student housing?

Yes

Course Registration at 51��

51��'s Class Schedule will be available on April 15. In order to review classes before that date, please use the course information in the 51�� . There you will find course descriptions and prerequisite requirements for all courses. Be sure that you have completed the prerequisite (or an equivalent) before selecting the course.

After receiving approval from the International Programs Office, you will need to complete a Registration Form sent by the Registrar’s Office indicating the courses you wish to register for in the upcoming semester. You will select those courses from the upcoming .

Students accepted to 51�� for the fall semester or the full academic year must submit their registration form by May 15. Students accepted to 51�� for the spring semester should submit their registration form by November 15. The includes the specific times and days when the class meets. Be sure to select courses that do not overlap and for which you have completed the required coursework.

Documentation

Please provide your most recent transcript, one letter of recommendation from a faculty member, home school endorsement, and a copy of the photo page of your passport. All provided documentation will be handled securely and access limited as per the 51�� Data Privacy Policy.

Maximum file size is 10mb; .pdf, .doc, .docx, .png, or .jpg only. Please check the format and size of your document before uploading.

Document

Financial Guarantee

If your application is accepted, you will then be asked to provide evidence that you have sufficient funds to support yourself while you are abroad. This may include proof of your student loan, bank statements, or a financial guarantee from a parent or a bank.

Authorization to Release an Academic Transcript

By submitting this form, I confirm that I am the applicant and the above information is true and accurate. If I am accepted and participate in the program, I authorize 51�� to release an official transcript to my home university upon completion of the program. I understand that the Family Educational Rights and Privacy Act (FERPA) generally requires my written consent for such a release, and I agree that the submission of this application constitutes that consent.

51����

International Programs Office