Application for admission Please print or type clearly in English and in BLOCK letters and return your application to your local representative or email to naadmissions@studygroup.com Please tick boxes where appropriate Please note all sections are mandatory We are unable to process an application unless we have full details of the student applying for the Master’s International Year Program Local representative information Counselor name Agency/Branch Email URN Program application UVM Master’s International Year Program Applicants Pre-requisite coursework must be complete to qualify for all Master’s International Year programs All Master’s International Year programs are semesters in length and begin in August only For which degree are you applying? (required) MS Biomedical Engineering MS Civil and Environmental Engineering MS Electrical Engineering MS Materials Science MS Mechanical Engineering MS Pharmacology MS Physics MS Statistics MS Mathematics Student details Family name(s) (as it appears in passport) Given name(s) (as it appears in passport) Title Date of birth (mm/dd/yyyy) Country of birth Age Gender: M F First language Country of citizenship/nationality Permanent home mailing 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 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 Upon confirmation you will also need to complete the UVM SEVIS I-20 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 Are you a permanent resident of the U.S or you currently hold a valid U.S passport? Yes No (please tick) No (please tick) *Student’s mailing address is required for I-20 mailing purposes Application checklist and required documentation: A complete and signed application form including intended degree program, email address and telephone number Certified, full transcripts of all academic qualifications, translated into English with the translation authenticated Grading system explanation sheet Certified, proof of graduation, translated into English with the translation authenticated if available at the time of application O fficial test scores from English language proficiency test: IELTS or TOEFL Copy of identification pages of your passport Current I-20, I-94 and visa, if applicable If admitted, I-20 SEVIS Transfer form will also be required O ne signed letter of recommendation R esume required for candidates with work experience post UG studies VERM-PMP-APP-I Original, sealed academic transcripts and school leaving certificate are required prior to or upon arrival at the University of Vermont Official records may be sent by the previous institution directly to UVM prior to orientation UVM, Graduate College, 330 Waterman Bldg, 85 South Prospect Street, Burlington, Vermont 05405 E: naadmissions@studygroup.com W: globalgateway.uvm.edu Previous education Please give details of all the 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 Institution city and country Date attended (mm/yyyy) Grades/results From To From To From To Primary language of instruction What is your most recent institution’s primary language of instruction? Standardized testing Please enclose copies of your test score reports, if applicable IELTS TOEFL iBT (score/date) (score/date) Additional information Parent, Guardian or Sponsor contact Name Relationship to student Home address (if different from student address) Country City/Postcode Home telephone number (including country code) Mobile telephone number (including country code) Email Country of citizenship Payment of tuition fees Self Parent/guardian Company sponsor Government sponsor (please tick) Please give full name of sponsor Accommodation UVM Master’s International Year students will be offered housing in the first year of graduate studies Housing is guaranteed upon confirmation Student insurance International students will be automatically enrolled in UVM’s student insurance Visit uvm.edu/health/insurance Criminal and disciplinary record Other than traffic violations, have you ever been convicted of a misdemeanor, felony or other crime? Yes No Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution Yes No If you answered yes to either of the above, submit a full statement of relevant facts (including approximate date of the incident/s) on a separate sheet of paper, marked with your name and date of birth Please turn to page to sign the declaration UVM, Graduate College, 330 Waterman Bldg, 85 South Prospect Street, Burlington, Vermont 05405 E: naadmissions@studygroup.com W: globalgateway.uvm.edu Confirmation procedure If admitted, you will receive a letter of admission which needs to be confirmed by paying the deposit The university will then issue the I-20 and you will receive the Global Gateway Terms and Conditions and pre-arrival details featuring further instructions Declaration Agreement and release: Applicant I am the applicant for the program that is the subject of the Master’s International Year Program I accept all of the conditions as stated herein and acknowledge that I have had adequate time to review these Terms and Conditions and that I fully understand the Terms and Conditions and my responsibilities under them I agree to pay all fees as they become due and as described in the Terms and Conditions Further, in the event of cancellation under these Terms and Conditions, I agree to either give the required notice of cancellation or to pay the required fees in lieu of notice I certify that all information submitted in the application process – including the application, the personal essay, and any other supporting materials – is my own work, factually true, and honestly presented and that these documents will become the property of the University of Vermont and will not be returned to me I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, denied access to transcripts and degree, if the information I have certified to be true is in fact false or does not match the documentation submitted to make an admissions decision I understand that I will be tested for English proficiency, and the results of such testing may lead to changes in my admission to the Master’s International Year If the results are significantly different than the results submitted with my application, UVM requires that I leave the Master’s International Year Program to strengthen my English proficiency and revoke admission into the Master’s Program I have indicated I understand that I am subject to the laws of the country and state where I will be studying as well as the rules, policies and regulations of University I also understand that it is my responsibility to be informed about the laws, regulations and policies and to conduct myself in a manner that complies with those laws, regulations and policies I assume full responsibility for any personal activities in which I participate that are outside the scope of the program and required course work I further assume full responsibility for my personal conduct while participating in the program and my required course work I understand that I am wholly and personally responsible for any and all damage to property or persons I may cause while I am enrolled in this program I understand that my participation in the program may be terminated at the discretion of Study Group USA Higher Education LLC without any refund of fees and that I may be sent home at my sole expense if I not adhere to the U.S., State, and local laws and University of Vermont policies or rules I agree to accept full responsibility for personal expenses, books, fees related to my program of study, any required additional language training and round trip air fare I understand that my participation in the program that is the subject of the Terms and Conditions is voluntary and I voluntarily assume all risks of injury to myself or damage to my property and agree to hold harmless Study Group USA Higher Education LLC, the University of Vermont, and their officers, directors, employees and authorized agents from any and all liability, claims, or causes of action arising out of my participation in the program or transportation to and from Burlington, Vermont In the event that Study Group USA Higher Education LLC, the University of Vermont, or their agents advance or loan any funds to me or incur special expenses on my behalf, I agree to make immediate repayment to Study Group USA Higher Education LLC I understand that this Agreement cannot be modified except in a writing signed by Study Group USA Higher Education LLC By ticking this box I confirm the following: • I am the applicant • All information submitted in the admission process – including this application and any other supporting materials – is 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 • I accept all of the Terms and Conditions as stated herein Full name (English signatory) Date (mm/dd/yyyy) How did you hear about us? Choose one of the following: Counselor Educational Fair Website Friend/relative recommendation Other (please specify) 30641 MIY_07/19 Any offer will be made subject to acceptance of our Terms and Conditions The current Global Gateway Program Terms and Conditions can be viewed at globalgateway.uvm.edu/-/media/ISC/Vermont/PDFs/TermsConditions.pdf UVM, Graduate College, 330 Waterman Bldg, 85 South Prospect Street, Burlington, Vermont 05405 E: naadmissions@studygroup.com W: globalgateway.uvm.edu Appendix UVM Graduate College Personal Statement Questions (Required by UVM) Please tell us why you are interested in this field of study Please describe your academic qualifications which have prepared you for this degree program If you have worked in addition to your education, please describe your professional qualifications or experience for this degree program (If you not have professional work experience, please answer the question as “N/A”.) Letter of Recommendation Guidelines •M ust be on appropriate letterhead • Must be signed and dated by the author Degree programs Degree MS Biomedical Engineering MS Civil and Environmental Engineering MS Electrical Engineering MS Materials Science MS Mathematics MS Mechanical Engineering MS Pharmacology MS Physics MS Statistics