*This option for transfer students only. Last Name (Surname) First Name (Given) Middle Preferred Name (Nickname) Last Name First Name Middle

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1 Please submit your $50 application fee (Online application fee is $40: Choose one: o FRESHMAN o TRANSFER Choose one: o FULL-TIME o PART-TIME Choose a term of entry: o Fall, August o Spring, January o Summer, May * PERSONAL information PRINT YOUR NAME BELOW EXACTLY AS IT APPEARS ON YOUR SOCIAL SECURITY CARD OR PASSPORT UNDERGRADUATE ADMission APPLICAtion FOR international Students *This option for transfer students only. Last Name (Surname) First Name (Given) Middle Preferred Name (Nickname) INTENDED MAJOR OR FIELD OF STUDY (required) Major Code Social Security NUMBER DATE OF BIRTH Age GENDER o Male o Female Optional mm/dd/yyyy List ANY OTHER NAMES (or OTHER SPELLINGS) UNDER WHICH YOU WERE ENROLLED AT ANOTHER INSTITUTION: Last Name First Name Middle Do YOU PLAN TO RESIDE IN UNIVERSITY HOUSING DURING YOUR FIRST YEAR AT FLORIDA TECH? o Yes o No Do YOU WANT TO BE CONSIDERED FOR THE FAST TRACK MASTER'S PROGRAM IN YOUR MAJOR AREA? o Yes o No PERMANENT ADDRESS Street Phone Cell Phone Language Spoken in the Home Country of Citizenship City of Birth Country of Birth MAILING ADDRESS (if different than permanent address) Street FATHER'S NAME (or Legal Guardian) Home Street Address Country Postal Code Daytime Phone Employer Occupation MOTHER S NAME (or Legal Guardian) Home Street Address Daytime Phone Employer Occupation My o mother o father o parents is/are alumni of Florida Tech. If you have a brother or sister enrolled at Florida Tech, please supply his/her name The following information is optional and will not, in any way, be used in a discriminatory manner. Are you applying for financial aid? o Yes o No Religious Preference Marital Status o Single o Married U.S. citizens, select all that apply: o Hispanic or Latino o American Indian or Alaska Native o Asian o Black or African American o Native Hawaiian or other Pacific Islander o White *Non-U.S. citizens, select one: o International (non-u.s. citizen) o Permanent Resident or Resident Alien of the U.S. * (if a resident alien, please send a copy of both sides of resident alien card to the Office of Admission) 25

2 Academic Experience List all educational institutions attended, starting with the most current. Please list all high schools, secondary schools, colleges and/or universities you have attended. Use a separate sheet of paper if necessary. DATES attended CERTIFICATES/DIPLOMAS YEAR of COMPLETION/ NAME of INSTITUTION CITY/COUNTRY FROM UNTIL DEGREES received GRADUATION Have you applied to Florida Tech in the past? o Yes o No If yes, when? Have you previously attended Florida Tech? o Yes o No If yes, when? Have you ever been convicted of anything other than a traffic violation? o Yes o No If yes, please explain: Please check all that apply: o I have taken one or more Advanced Placement (AP) examinations o I am pursuing an Army ROTC scholarship o I am a Florida Tech INTEL Science Fair Scholarship recipient o I have one or more pilot certificates or have some flight experience o I am pursuing an International Baccalaureate program If you are applying as a first-year student, please enter the following additional information: Guidance Counselor Name or Headmaster Counseling Office Phone Guidance Counselor High School Web Address Have you ever taken or are you scheduled to take the SAT I? o Yes o No Have you ever taken or are you scheduled to take the ACT? o Yes o No If yes, have you had your scores sent to Florida Tech? o Yes o No Have you taken the TOEFL? o Yes o No Extracurricular Activities Please list any extracurricular activities, hobbies and employment in which you have been involved. Check the left column beside any activity you would like to continue to participate in at Florida Tech. You may use the space below or attach an additional sheet of paper. CHECK MARK ACTIVITY YEARS of PARTICIPATION POSITIONS HELD/HONORS EARNED Referral Information How did you first learn about Florida Tech (check all that apply and supply the appropriate name(s)): o Teacher o College Fair o Florida Tech Applicant o Friend o Florida Tech Professor o Florida Tech Representative o Counselor o Florida Tech Student o Other o Publication o Florida Tech Alumnus What led you to apply to Florida Tech? Please sign your application. Your signature indicates that you understand that Florida Tech reserves the right to rescind an offer of admission if any information provided on this application proves to be false. Signature Date 26

3 UNDERGRADUATE I-20 RequEST I-20 Requirements Information (Please check below if you do not require an I-20) o I do not require an I-20 because I am a U.S. Permanent Resident (send a copy of both sides of resident alien card) ALL international applicants who need an I-20 to obtain an F-1 Student Visa must complete the section below. Transfer students attending an American university with an I-20 will need a new I-20 issued from Florida Tech. o Yes, I require an I-20 for F-1 Student Visa, and o I plan to come alone o I am bringing the following dependents COUNTRY OF CITY AND Name as it appears on PASSPORT CITIZENSHIP Relationship Date of Birth COUNTRY of Birth Carefully read and follow the requirements for each item listed below. An I-20 will NOT be issued until we receive this form and the following items. Be sure to obtain a duplicate of financial documents for presentation to the Consular Officer to obtain your visa. Funds FROM PERSONAL FUNDS, FAMILY OR FRIENDS NOT in the U.S. (Submit item A see list below.) Relationship to applicant Funds FROM FAMILY, FRIENDS OR RELATIVES who reside in the U.S. (Submit items A and B see list below. Sponsorship by Government (If government funds are equal to the amount of support required, submit item C; if less than this amount, submit items A and C for the balance see list below.) Name of government Sponsorship by Non-Government Agency (Submit items A and C see list below.) Name of agency Assured Support First Year I-20 Checklist To receive an I-20, you must submit the following: 1. A copy of your passport 2. An original bank letter 3. Your complete international street address (a P.O. Box will not be accepted) 4. A completed and signed Undergraduate I-20 Request form 5. A completed Transfer Eligibility Statement (for students currently attending school in the U.S.) A. certified bank letter that 1. is an original (copies will not be accepted); 2. is certified (a bank seal or stamp must appear on the bank letter); 3. is a document that states at least the amount (in dollars) required for what you plan to study (see Comprehensive Charges chart), additional funds must be added for dependents (include U.S. dollar exchange rate); and 4. is not over 12 months old from the date you plan to attend Florida Tech. B. Affidavit of Support form (I-134, if using a U.S. sponsor). This form must be 1. an original, and will be required to obtain your visa from the embassy; 2. notarized; 3. not over 12 months old from the date you plan to attend; and 4. able to demonstrate support for at least the amount required for what you plan to study (see Comprehensive Charges chart). C. sponsorship letter that 1. is an original (copies will not be accepted); 2. is not over 12 months old from the date you plan to attend; 3. is a clear outline of specific dollar amounts and items the sponsorship covers (see Comprehensive Charges chart); 4. is an original letter from sponsor or sponsoring agency stating their guarantee to finance your education; and 5. is a document containing billing instructions. Only sponsors in the United States will be billed directly. Students sponsored outside the United states must make private arrangements for payment of fees, unless the sponsoring agency maintains a U.S. billing address. 27

4 FLORIDA TECH Comprehensive charges for two semesters* College of Aeronautics with flight... $56,860 College of Aeronautics without flight... $42,090 Nathan M. Bisk College of Business... $42,090 College of Engineering... $44,690 College of Science... $44,690 College of Psychology and Liberal Arts... $42,090 *Includes tuition, room, board, books, fees, insurance and personal expenses. Fees subject to change. I-20 Mailing Instructions The I-20 will be sent with your admission packet by Air Mail. IMPORTANT: Provide below the address where you wish your admission packet and I-20 to be sent. You MUST include a phone number. Your name exactly as it appears on your passport: Last First Middle Surname Given Address Telephone (required) Mail this completed form to the Office of Undergraduate Admission or fax it to (321) I understand that falsification of any information on this application is grounds for immediate dismissal. Signature of Applicant Date 28

5 Confidential Letter of RecoMMendation for Undergraduate Admission Section 1 To be completed by applicant Name Last Name First Name Middle Initial Intended Major Term of Entry I have submitted an application for undergraduate admission to Florida Tech. I understand that this recommendation is confidential and will not be released either to myself or a third party, and will be used only in the evaluation of my application. I hereby understand and agree to the use of this recommendation for admission evaluation. Signature of Applicant Section 2 To be completed by recommender The student named above is applying for admission to Florida Tech. We are interested in your honest and candid appraisal of his/her academic abilities, quality of his/her work and your evaluation of his/her potential to succeed in an academically challenging curriculum. Your evaluation is important and will be an integral element in our decision process. Recommender please return this form as soon as possible to: Name Florida Institute of Technology Office of Undergraduate Admission Phone 150 W. University Blvd., Melbourne, FL Please Attach Your Business Card _Phone (321) Fax (321) Creative Original Thought Motivation Perseverance Independence/Initiative Problem Solving/Critical Thinking Academic Achievement Analytical Ability Effective Class Discussion Disciplined Work Habits Potential for Growth Participation in Group Exercises WELL BELOW BELOW AVERAGE ABOVE WELL ABOVE CANNOT AVERAGE AVERAGE AVERAGE AVERAGE COMMENT Additional Comments (use reverse side if necessary) Academic Recommender (guidance counselor, teacher): Please attach an evaluation, written on letterhead, of this student s quality of academic work and potential to succeed in an academically challenging curriculum. Also indicate any areas of strength, weakness or room for improvement. Please include a description of your affiliation with the student and for how long. Non-Academic Recommender (coach, employer, other): Please attach an evaluation, written on letterhead, of this student s potential to succeed in an academically challenging curriculum. Also indicate any areas of strength, weakness or room for improvement. Include a description of your affiliation with the student and for how long. Signature of Recommender Date Confidentiality: This form will be retained in the student s file only for the admission period. Once the applicant has matriculated, this form and all such materials will be destroyed. In accordance with the Family Educational Rights and Privacy Act of 1974, matriculating students do have access to their permanent files, but they will not include forms such as this. Florida Institute of Technology does not provide access to admission records to applicants, students who are denied admission or students who decline an offer of admission. These university policies may be of assistance to you as you complete this form. 29