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DS2019 NON-DEGREE STUDENT REQUEST FORM

Maximum time limit: 24months (including academic training)


Type  


PERSONAL INFORMATION

Student's Last(Family) Name Middle Name First Name
Gender Birthday (MM-DD-YYYY)
City of Birth
Country of Birth Country of Citizenship Country of Permanent Residence
Position in Home Country Permanent Mailing Address Email Address

FINANCIAL SUPPORT

*Financial documentation must be attached in the form of a bank statement/letter on bank letterhead, not older than
90 days, signed and dated by the bank manager, verifying the availability of at least $1,500 per month or $7,500 per
semester. 

SIUE provides a tuition waiver of approximately $7500 per semester. Exchange Students are responsible for paying associated SIUE fees.

Please fill only the personal funds box.

SIUE ($) Personal Funds ($)

ENGLISH ABILITY

TOEFL requirement - 79 or higher on the iBT; 213 or higher on the CBT; 550 or higher on PBT or Institutional TOEFL
IELTS requirement - overall band score of 6.5*Research Scholars who are not teaching or attending classes may submit a letter from appropriate University faculty at your present institution attesting to English ability.A letter on Home Institution letterhead must be attached indicating the amount of the award or Financial documentation must be attached in the form of a bank statement/letter on bank letterhead, not older than 90 days, signed and dated by the bank manager.
TOEFL or IELTS score - (no older than 2 years-must be attached)

PROGRAM INFORMATION

The category of this visitor is: (Please click below) Maximum Time limit:
Student

1 Year


PROGRAM OBJECTIVE

Applicant must provide a specific description of their objective: (Example: To participate in research on the policies, management and practices of wastewater biosolids disposal.)

I AM REQUESTING TO:
(Please select appropriate option below)

Begin New Program in U.S.
Transfer from another U.S. school
*Attach copy of current DS2019

Date to begin at SIUE:       Date to end:   


Hiring Authority Information:

Chair/Hiring Authority Name Title Department
Phone E-mail Fax number
Date


SIUE International Student Services, Box 1616, Edwardsville, IL, 62026-1616
Phone: 618-650-3785     Fax: 618-650-5099


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