Missouri University of Science and Technology, Applied Language Institute

Applied Language Institute
103 Norwood Hall
320 W. 12th St.
Rolla, MO 65409
(573) 341-4208
ia@mst.edu

Application For Admission

Name

First
Last

Gender

Male

Female

Address in U.S. (if any):

Number and Street
City/State/Zip

Address in Your Country:

Number and Street
City
Country

Contact Information:

Telephone
Fax or e-mail

Date of Birth:

Day

Month

Year

Country of Birth
Country of Citizenship

8 Week Session Requested (Please check one)
Summer (June/July)
Fall (August-December)
Midterm (October-December)*
Winter (January-May)
Midterm (March-May)*

*Note: Mid-term enrollment is permitted, but students are encouraged to enter programs at the beginning of the semester in order to complete a full session of study.

Will you need an I-20?
Yes No

If yes, your application cannot be considered until we receive proof of financial support (e.g. bank statement, certified letter, etc.) for nine months of study. See estimated cost information.

Are you currently attending a school in the U.S.?
Yes No

A $50.00 non-refundable application fee must be sent with your application for admission.
Make Checks Payable to Missouri S&T (major credit cards are accepted)
(U.S. Dollars, drawn on a U.S. Bank)
Mail application fee and letter of financial support to:

Director, Office of International Affairs International Affairs 1870 Miner Circle 103 Norwood Hall Missouri University of Science and Technology Rolla, MO 65409-0160 Telephone: (573) 341-4208 FAX: (573) 341-6356 E-mail: ia.mst.edu
Please or