MASTER'S ACCELERATOR APPLICATION

Personal Details

As it Appears on Your Passport

Given Name/First Name

Surname/Last Name

Gender

Date of Birth

Day

DD

Month

MM

Year

YYYY

City of Birth

Country of Birth

Country of Citizenship

Passport Number

Passport Date of Expiration

Day

DD

Month

MM

Year

YYYY

Address and Contact Details

Permanent Non-US Home Address

Street Address 1

Street Address 2

Street Address 3

City

Region/State/Province

Postal Code

Country

Are you currently living in the United States?

U.S. Street Address 1

U.S. Street Address 2

U.S. Street Address 3

City

State

Zip Code

Please enter a valid 5 digit US Zip Code.

U.S. Mobile Area Code

U.S. Mobile Phone

Primary Home Phone

International Code

Area Code

Telephone

Primary Mobile Phone

International Code

Area Code

Telephone

Applicant's Email Address

Emergency Contact

Given Name/First Name

Surname/Last Name

Relationship

Street Address 1

Street Address 2

Street Address 3

City

State/Province

Postal code

Country

E-mail

Primary Home Telephone

International Code

Area Code

Home telephone

Primary Mobile Telephone

International Code

Area Code

Mobile Telephone

Additional Information

Form I-20

Do you have a Form I-20 from another institution in the United States?

Select “Yes” only if you are currently studying on an F1 student visa in the United States, and have been issued an I-20 document from your current institution within the United States. If Yes or Yes - Expired please provide a copy with your application materials.

I-20 End Date

Day

DD

Month

MM

Year

YYYY

Dependents

Dependents are defined as spouses and/or unmarried children under 21.

Do you have dependents you would like to add to your I-20?

YesNo

Medical Insurance Requirement

I understand that I will be required to purchase medical insurance for the full duration of my program upon my arrival in the United States.

Yes

Sponsored Students

Sponsored Students are defined as any student receiving a sponsorship from their local government, organization, or agency.

Will any part of your education be sponsored?

YesNo

Sponsorship Details

Name of the sponsor body

Name of anticipated sponsor body

Additional Information

Your application will not be reviewed without a Copy of Academic Transcript and a Copy of Official English Assessment Score Report. Accepted students must bring original copies of all materials when arriving on campus.

Upload Academic Transcripts

Upload Official English Assessment Score Report

Upload Passport

Upload Bank Statement

CV or Personal Statement (if applicable)

Additional Files (if applicable)

UNIVERSITY TERMS & CONDITIONS

I have read and understand the published enrollment contract for the Adelphi International Master’s Accelerator Program I have selected on my application, and understand that the most updated copy may be found at the Adelphi International’s website on the link listed below: aui.adelphi.edu/enrollment-contract/.

Declaration

I declare that the information I have supplied on this form is complete and correct. I understand that giving false or incomplete information may lead to the refusal of my application or cancellation of enrollment and/or loss of visa status.

I have read and understand the published course information in the brochure or website, and I have sufficient information about Adelphi University and Adelphi International, including the Master's Accelerator Program (MAP), to make an informed enrollment decision.

I give Adelphi University and Adelphi International permission to obtain official records from any educational institution attended by me.

I understand that after I commence my studies with Adelphi International, I will need to successfully complete the program and meet the minimum required progression standards before I can continue my studies at Adelphi University.

I understand that tuition and fees may change without notice. I accept responsibility for payment of all relevant tuition and fees, and I agree to abide by the Adelphi International refund policy.

I understand that living expenses in the United States may be higher than in my own country, and I confirm that I have the financial ability to meet these costs.

I understand that I will live at Amity University and Institution's Oakdale, NY property for a minimum of 2 semesters.

I have read and understand the published program enrollment contract and understand that the most updated copy may be found at https://aui.adelphi.edu/enrollment-contract/.

NOTICE OF NON-DISCRIMINATION

Discrimination, harassment (including sexual misconduct), and retaliation of any type will not be tolerated at Adelphi University. Upon notice, the University will act to end the discrimination, harassment or retaliation; prevent its recurrence; and remedy its effects on the victim and the University community. If you have any questions or concerns about discrimination, harassment (including sexual misconduct), and/or resulting retaliation, or if you need help in resolving a problem, I strongly encourage you to contact the Title IX Coordinator at titleix@adelphi.edu or 516.877.4819.