Merrimack College
Transcription
Merrimack College
Application for enrollment Please print clearly in English and in BLOCK letters and return your application to your local representative or email to [email protected] Please tick boxes where appropriate. Please note all sections are compulsory. We are unable to process an application unless we have full details of the student applying for the program. Local representative information Representative name Branch Email URN Student details Family name(s) (as appears in passport) Given name(s) (as appears in passport) Title Age Date of birth (mm/dd/yyyy) Country of birth Gender: M F First language Country of Citizenship/Nationality Home address (including city) Country City/Postcode Current address (if different from home address) Email Home telephone number (including country code) Mobile telephone number (including country code) Do you have a spouse and/or children that will be accompanying you to the USA as of the date you will begin classes at the university? Yes No (please tick) Do you currently hold a valid I-20 from another U.S. school? Yes No (please tick) If Yes, please attach a copy of your current I-20, visa and I-94 card. You also need to complete the Merrimack College I-20 SEVIS Transfer Form. Are you currently in the U.S. on another non-immigrant visa (examples: B-1/B-2, F-2, etc.)? Yes If Yes, please attach a copy of your current non-immigrant visa. No (please tick) Intended start When would you like to start? August January May (please tick) Intended degree program Refer to Appendix for Merrimack College degree options. University degree program (e.g. Management) (required) Application checklist and required documentation: Complete and accurate application form including intended degree program, email address and telephone number Scanned, certified, full transcripts of all your academic qualifications in native language and translated into English with the translation authenticated A scanned copy of official test scores from an English Language Test such as IELTS, TOEFL iBT or the free Password Test Resume/CV A copy of the identification pages of your passport A copy of your current I-20 and visa, if applicable A scanned copy of a certified bank statement (within 3 months) translated in English indicating sufficient funds including amount available Original, sealed academic transcripts and credential completion document MUST be submitted prior to or upon arrival at Merrimack College. Official records may be sent to Merrimack College directly by the previous institution prior to orientation. MERR-APP-I 1 Previous education Please give details of all the secondary school, college, university, and English language schools you have attended. Please include full, scanned, certified transcripts of all your academic qualifications, translated into English along with translation authenticated by a notary public or similar official. Institution name (include city and country) Date attended (mm/yyyy)Subject/major From To From To From To From To From To Grades/results Standardized testing Please enclose copies of your test score reports, if applicable. Original copies are required to start classes. IELTS (score) TOEFL iBT (score) Password (score) Pearson (score) GRE / GMAT (score) Embassy English (level) Primary language of instruction What is your Undergraduate primary language of instruction? Additional information Payment of tuition fees Self Parent/guardian Company sponsor Government sponsor (please tick) Please give full name of sponsor Accommodation Students in the Pre-Master’s Program live in Merrimack campus housing and have a minimum of a 5 meal per week dining plan. This housing is apartment-style with 4-6 students living in each unit. The units are furnished, have kitchens and are supported by designated staff and services. You will be sent information on housing arrangements upon offer of admission. In the unlikely event campus housing becomes unavailable, staff at the ISC will help students book off-campus housing. It is important to note that off-campus housing options are very limited, likely unfurnished and may require a car, so we recommend you confirm early to ensure a space in the on-campus residences. If you have a special situation that you feel may require off-campus housing, please provide additional information here. Student insurance The Commonwealth of Massachusetts mandates that all students be covered by health insurance. To ensure compliance, Merrimack students are automatically enrolled in a compliant health insurance plan. You may be eligible to waive this insurance if you have alternative adequate coverage. For full details, visit www.merrimack.edu/admission/tuition/student-health-insurance.php Will you require Merrimack College health insurance? Yes No (please tick) no, you will be required to complete a waiver if you are admitted, after confirming your place. If Criminal and disciplinary record Other than traffic violations, have you ever been convicted of a misdemeanor, felony or other crime? Yes No (please tick) Have you ever been charged, suspended, removed, dismissed or expelled from any educational institution for academic or disciplinary reasons? Yes No (please tick) If you answered yes to either of the above, submit a separate, full, signed statement of relevant facts. How did you hear about us? Choose one of the following: Agent Educational Fair Website Friend/relative recommendation Other (please specify) Please turn to page 3 to sign the declaration 2 Confirmation procedure Once we receive your completed application it will be evaluated for admission and a decision will be issued within 2-5 working days. If admitted, you will receive an offer of admission which needs to be confirmed by paying the deposit. The university will then issue the I-20 and you will receive pre-arrival details featuring further instructions. Declaration Acceptance – by the student I apply to enroll the person named as a student of Merrimack College. I undertake to pay all tuition and accommodation fees incurred by the student as they become due in accordance with the Terms and Conditions and, where relevant, either to give the required notice of cancellation or to pay the required fees in lieu of notice. By ticking this box I confirm the following: • I am the student, or have the full and express authority and consent of the student to submit this application on their behalf. • All information submitted in the admission process – including this application and any other supporting materials – is complete, factually true and honestly presented. • I understand that I may be subject to a range of possible disciplinary actions should the information I have confirmed above be false. Full name (signatory) Date (mm/dd/yyyy) Any Offer will be made subject to acceptance of our terms and conditions. The current terms and conditions can be viewed at isc.merrimack.edu/terms-and-conditions Merrimack College, 315 Turnpike Street, North Andover, MA 01845 20165_PEGA 04/15 3 Appendix Resume/CV Applicant’s resume or CV should contain a summary of education, training, and paid and unpaid experience. You may also include relevant research or project descriptions, software skills, activities, awards, and interests. Merrimack College Pre-Master’s Program Degrees Progression Degree Degree Designation Management Accounting Civil Engineering Mechanical Engineering MS MS MS MS 4