State University of New York College at Cortland

ON-LINE APPLICATION FORM

Please complete all information. If your browser software does not support foms, send e-mail to studyabroad@cortland.edu to receive an application. You can also Download a copy of the SUNY Application in PDF Format.

Date of Application:

Biographic Data

Name:
Last, First, Initial

Your e-mail address:

Program:
Administering Campus:
Location Abroad:

I.D. Number: (College or Social Security)

Home Campus:

Study Period for which you are applying - select a period and year
Period: Year:

Birth Date: (Month/Day/Year)

Gender: Male Female

Marital Status:

Country of Citizenship

Visa status if not a U.S. citizen:

Campus Address:

Campus Phone Number:

Permanent Address:

Permanent Phone Number:

If you are under 21, Name and Address of Parent or Guardian
Name:
Address:
Phone Number:

Name and Address of person to contact in case of emergency, if other than Parent or Guardian listed above:
Name:
Address:
Phone Number:

Academic Background

Major or Prospecive Major: Minor:

Spcialty within major field, e.g. piano, sculpture, Russian history, etc.

Grade Point Average:
In major field: Cumulative:

Semester Credits completed to date:
Undergraduate: Graduate

Academic Advisor's Name:

Colleges or Universities Attended (List Name, Dates, Degrees, and Honors)

Language courses you will have taken prior to the beginning of the program that would be of value in preparing to converse or understand instrucion abroad: (include title, credits and grades; indicate High School or College)

Estimate your proficiency in the language of greatest importance in the program (except English): Language:
Speaking
Listening
Reading
Writing

List Coure(s) other than those listed under Language Courses, above, which you have taken or are taking that are related to the program (include title, credits and grades; indicate if High School or College):

Miscellaneous

Please describe your plans for financing your participation in an overseas study program:

State briefly any additional information that may be useful to the selection committee in evaluating your candidacy, including any travel or residence in other countries or other regions of the United States:

For further information contact:

 International Programs Office
B -15 Old Main
SUNY College at Cortland
P.O. Box 2000
Cortland, NY 13045
Tel: (607) 753-2209
Fax: (607) 753-5989
E-mail: StudyAbroad@snycorva.Cortland.edu


[Home] [General Information] [Inquiry Form] [On-Line Application]

© 1996-1997 SUNY Cortland
SUNY Cortland is an Equal Opportunity Institution

State University of New York and the College at Cortland do not discriminate on the basis of race, sex, religion, national origin, age, sexual orientation, disability or marital status in admissions, employment, and treatment of students and employees.