Global First Year Application Page 2
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1
2
3ONLINE APPLICATION: V1
EDUCATION DETAILS
PERSONAL STATEMENT
(CONTINUED)
Advanced Tests (if applicable)
1. Have you ever been subject to disciplinary action or do you currently have a
disciplinary charge pending by any educational institution for academic misconduct,
SAT total score:
SAT date (DD/MM/YY):
such as cheating? (You do not need to disclose any academic dismissal, suspension
or probation that was due to poor grades.)
CR score:
Math score:
Yes
No
ACT scores:
ACT date (DD/MM/YY):
2. Have you ever been subject to disciplinary action or do you currently have a disciplinary
Composite:
Math:
English:
charge pending by any educational institution for behavior misconduct, such as fighting?
Other test:
Other test date (DD/MM/YY):
Yes
No
3. Have you ever been convicted of, or charged with, a criminal offense or are you
currently the subject of any criminal proceeding?
TRANSFER INFORMATION
Yes
No
Required if transferring from another educational institution in United States.
If you have answered yes to either of the above questions, please submit a separate
City/State/Country: ______________________________________________________
sheet that gives the circumstances and approximate date of each incident.
From DD/MM/YY to DD/MM/YY __________________________________________
DECLARATION
Degree earned: _________________________________________________________
I declare that the information I have supplied on this form is complete and correct.
I understand that giving false or incomplete information may lead to the refusal of my
application or cancellation of enrollment and/or loss of visa status.
Transferring school: _____________________________________________________
I have read and understand the published course information in the brochure or
SEVIS #: ______________________________________________________________
website, and I have sufficient information about Florida International University (FIU) and
the Global First Year (G1Y) to make an informed enrollment decision.
DEPENDENTS
I give FIU and the G1Y permission to obtain official records from any educational
Do you have dependents you would like to add to your I-20?
institution attended by me. I give FIU permission to provide the G1Y with any information
pertaining to my application of study, my ongoing academic progress, and my results and
Yes
No
attendance for the purposes of evaluating my admissibility and progression status.
AIRPORT RECEPTION
I grant FIU and the G1Y permission to provide my parent(s), guardian(s), sponsor(s),
and recruiter, when requested, with any information pertaining to my application to study,
Do you require airport pickup? After you book your travel, please visit
ongoing academic progress, results, attendance and disciplinary record for the purpose
and enter your arrival details and flight information.
of facilitating family communications about the university experience.
Yes
No
I understand that after I commence my studies with the G1Y, I will need to
successfully complete the program and meet the minimum required progression
MEDICAL INSURANCE REQUIREMENT
standards before I can continue my studies at FIU.
(This section must be completed.)
I understand that tuition and fees may change without notice. I accept responsibility
for payment of all relevant tuition and fees, and I agree to abide by the G1Y refund policy.
I understand G1Y will provide a required 12 months of medical coverage upon
my arrival in the United States, at a cost of $2,000 USD. At the end of 12 months,
I understand that living expenses in the United States may be higher than in my own
I will be required to extend the initial coverage. This fee changes annually and is
country, and I confirm that I have the financial ability to meet these costs.
correct at the time of printing.
I have read and understand the attached program terms and conditions and under-
SPONSORED STUDENTS
stand that the most updated copy may be found at
Please indicate if any part of your education will sponsored.
APPLICANT’S SIGNATURE
Type of sponsorship (for example: tuition, fees, living expenses, other):
Name of sponsoring organization:
OTHER INFORMATION
Date (DD/MM/YY):
How did you first learn about FIU?
Exhibition or seminar
PARENT OR GUARDIAN SIGNATURE
(if applicant is under 18)
Newspaper or magazine
Recommendation from friend or colleague
Recommendation from recruiter
Name:
Internet search or advertisement
Date (DD/MM/YY):
Recommendation from family member
ADDITIONAL APPLICATION MATERIALS REQUIRED
APPLICATION SUBMISSION
Copy of passport (if available)
Scan and upload your completed application at
Copy of academic transcript
Copy of official English assessment score report
OFFICE USE ONLY
Copy of bank statements
Please note: Accepted students must bring original copies of all materials
Application received:
when arriving on campus.
Application number:
2
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