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INTENSIVE ENGLISH PROGRAM

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INTENSIVE ENGLISH PROGRAM
ADMISSIONS PROCEDURES AND PRIORITY APPLICATION DEADLINES:
For students NOT currently living or studying in the United States and applying from another country,
the Priority Deadline for timely processing to ensure time to obtain a student visa, if needed, is January 15, 2018
Please email and/or scan all items as attachments to IEP@tompkinscortland.edu
APPLICATION CHECKLIST
An Application for Admission, completed, signed, scanned, and emailed to IEP@tompkinscortland.edu
or sent via postal mail to the address above.
Copies of your TOEFL or IELTS score (Note: TOEFL minimum score: 42; IELTS minimum score: 4.5)
If you are already in the United States at the time of application and in proximity of Tompkins Cortland, you may
substitute the Accuplacer test.
A copy of your current passport identification page.
Additional information items will be required if a student visa is needed. It is not possible to attend the Intensive
English Program on a B-1/B-2 visa. Further information on how to obtain an I-20/DS-2019 to attend this program
is below on pages 3-4.
APPLICATION FOR INTENSIVE ENGLISH PROGRAM
When do you wish to attend the Intensive English Program (IEP) at Tompkins Cortland Community College? SUMMER___________
(YEAR)
PLEASE TYPE (OR PRINT LEGIBLY) YOUR NAME EXACTLY AS LISTED IN YOUR PASSPORT:
Family/Last Name____________________________________________________________________________________________________________________________
First or Given Name ________________________________________________________________Middle Name_____________________________________________
Birthdate __________/___________/___________
(MONTH/DAY/YEAR)
I will live on campus during the Intensive English Program Yes_________ No _________
SEND ALL APPLICATION MATERIALS TO:
Attention: Office of Global Initiatives
Tompkins Cortland Community College
170 North St., P.O. Box 139, Dryden, NY 13053
IEP@tompkinscortland.edu
PLEASE NOTE:
Application items may be SCANNED and sent as attachments to
IEP@tompkinscortland.edu
1.
COMPLETE PERMANENT HOME COUNTRY ADDRESS (REQUIRED):
Street Address or Location Description – CANNOT be only a P.O. Box ______________________________________________________________________
______________________________________________________________________________________________________________________________________
City _______________________________________ State/Province____________ Country________________________________ Postal Code _____________
CURRENT POSTAL ADDRESS (If different from above):
Street Address or Location Description – CANNOT be only a P.O. Box _______________________________________________________________________
_______________________________________________________________________________________________________________________________________
City _______________________________________ State/Province____________ Country________________________________ Postal Code _____________
Telephone Number:___________________________________________________________________________________________
Email Address:_______________________________________________________________________________________________
City and Country of Birth:______________________________________________________________________________________
Country of Citizenship:________________________________________________________________________________________
First Language:_______________________________________________________________________________________________
EMERGENCY CONTACT
Name:________________________________________________________________________________________________________________________________
Relationship to applicant:______________________________________________________________________________________
Email Address:________________________________________________________________________________________________
Phone Number:_______________________________________________________
Address:_________________________________________________________________________________________________________________________________
Language Spoken by Emergency Contact: __________________________________________________________________________________________________
INTENSIVE ENGLISH PROGRAM
2.
TO OBTAIN F-1 OR J-1 STUDENT VISA
The intensive nature of this program requires that most non-U.S. citizens or Permanent Residents must obtain a student visa.
Applicants may not join the program in B1/B2 tourist or visitor status. The following items are required for Tompkins Cortland to issue
a Certificate of Eligibility (I-20 or DS-2019), which can be taken to a U.S Consulate as part of the application process for such a visa.
Checklist of items to submit to obtain an I-20 or DS-2019
A completed questionnaire (below) for those applying for a Certificate of Eligibility
A bank statement from whomever is funding your program (either you or a sponsor) showing a minimum balance of $4,000
OR
If you have been awarded a government or other scholarship, you may substitute documentation of the scholarship for
the affidavit of support and bank statement, as long as it shows sufficient resources to cover all of your costs.
A signed Affidavit of Support from your sponsor, if somebody other than you is paying for the course (see below).
QUESTIONNAIRE TO OBTAIN A CERTIFICATE OF ELIGIBILITY
Will you require an I-20 or DS-2019 to come in F-1 or J-1 status? Yes_________ No _________
Are you currently in the U.S.A? Yes_________ No _________
If you are now in the U.S.A currently, will you remain here until the program starts or do you plan to travel to your home country first?
Yes_________ No _________
If you circled “Yes” that you are currently in the U.S.A. above, please circle one that applies to you.
U.S. citizen __________ Permanent Resident __________ Other __________
If you are already in the U.S. in “F-1” or “J-1” category, what institution is your current I-20/DS-2019 from?___________________________
During your studies, will you have any dependents* in living with you in the U.S.? Yes __________ No __________
*A note on dependents: Please be aware that you must show additional financial documentation to cover an additional
$200 per dependent. We are unable to house dependents in Campus Housing, so you must arrange alternative housing
for you and your dependent(s) if you plan to participate in the program.
INTENSIVE ENGLISH PROGRAM
3.
AFFIDAVIT OF SUPPORT
Individual Student or Sponsor’s Official Certification of Available Funds and Intention of Support
Name of Student ______________________________________________________________________________________________________________________
Student ID Number (if known) ______________________________________________________________________________
Name of Sponsor (If more than one, each sponsor should submit a separate affidavit) _______________________________________________________
Sponsor Address _____________________________________________________________________________________________________________________
Sponsor Email ________________________________________________________________________________________________________________________
Sponsor Phone Number ______________________________________________________________________________
My signature below certifies that it is my intention to fully support the educational and living expenses of the student named above for the
Tompkins Cortland Community College’s Intensive English Program.
Signature _________________________________________________________________________________________________________________________
Printed Name______________________________________________________________________________________________________________________
4.
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INTENSIVE ENGLISH PROGRAM

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Completed 21 September 2020

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