/ UC international
3134 Edwards One
PO Box 210640
Cincinnati, OH 45221-0640
Tel: 513-556-4278
Fax: 513-556-2990
Email:

UC INTERNATIONAL SUMMER PROGRAM APPLICATION

The UC International Summer Program is designed to provide international students an intensive and short-term educational program specifically tailored to meet the needs as communication by the partner institution overseas. The curriculum will consist of classroom instruction, laboratory work, and/or American cultural enrichment activities. You must complete this form fully and mail it to the address above with all required supporting documentation (Copy of University transcripts; English Proficiency Test Scores; Proof of Financial Support; copy of passport).

BIOGRAPHICAL INFORMATION

Please type or print your name clearly as it appears in your passport:

Name: ______

Last Name(s) First/Given Name Middle Initial

______

City of Birth Country of Birth

______

Country of Citizenship Country of Permanent Residence

ENGLISH PROFICIENCY REQUIREMENT

All applicants must demonstration English proficiency for the program of application. Please check the box indicating the English proficiency test you have taken from the following:

o TOEFL o IELTS o PEARSON

Test Score: ______

o Partner Certification (check this box if a partner institution is certifying your English proficiency.

o Studying in an approved English speaking country:

Antigua / Australia / Bahamas / Barbados / Barbuda / Belize / Bermuda / Canada (unless Quebec)
Denmark / Dominica / Fiji / Finland / Grand Caymen / Grenada / Irish Republic / Jamaica
Malawi / Netherlands / Nevis / New Zealand / Norway / Singapore / South Africa / Norway
Singapore / South Africa / St. Kitts / St. Lucia / St. Vincent Grenadines / Sweden / United Kingdom / Virgin Islands

INSTITUTIONAL/PROGRAM INFORMATION

College or University you currently attend:

______

Name of College/University

NAME AND CONTACT INFORMATION OF ACADEMIC ADVISOR AT HOME INSTITUTION

______

Name Title

______

Telephone E-mail

REQUIRED ATTACHMENTS

Please attach the following documents to this request:

·  Copy of University Transcript

·  English Proficiency Test Score

·  Basic Data Form

·  Proof of Financial Support for the program of study

·  Copy of Passport

Note: If the partner institution is certifying your English proficiency a letter from the academic contact certifying your English skills are sufficient for participation in the program is required.