special app 10-11
Office of Admissions
Massachusetts Institute of Technology Room 3-103 (S)
77 Massachusetts Avenue Cambridge, MA 02139-4307Phone (617) 253-2917mitspecial@https://www.sodocs.net/doc/84782503.html,
S P E C I A L S T U D E N T I N F O R M A T I O N S H E E T
SPECIAL STUDENT DEADLINES
U.S. Citizens and International
Permanent Residents Students Fall Term August 1 June 1Spring Term January 1 November 1Summer Term
May 1
March 1
A Special Student is someone who is enrolled in course work at MIT but is not registered as a candidate for a degree. Special Student status is available to individuals who have successfully completed a year or more of study at the university level. Secondary school students are not eligible. Special Student status is specifically designed for the following people:
? A n employed person who wishes to study subject material germane to employment.? A n individual interested in broadening his/her academic background in a particular field.
? A n undergraduate enrolled at another university who wishes to study subjects not offered at the home university.
Special students enjoy most of the privileges of matriculating students but are not eligible for campus housing or financial aid from MIT. Admission as a Special Student is valid for only one term (students must reapply each term) and does not imply admission as a degree c andidate at a later time.
SPECIAL STUDENT STATUS
A person seeking admission as a Special Student must apply through the Office of Admissions. Complete applications for a given term must be filed before the deadlines given above, including a $75 application fee. Only in extreme circumstances will an application be accepted after the deadline, and then only upon payment of a $40 late fee.
Persons applying for the first time must submit an Application for Special Student Admission, one Special Student Evaluation (from a teacher, dean, professor, or current work supervisor), and a certified transcript from each college previously attended. Special Students may not register for thesis, research (UROP for undergraduates), IAP , or other subjects for degree candidates only. Regular students will be given preference for registration in subjects with limited enrollments. All applications will be reviewed by both the Office of Admissions and the relevant department(s).
Applicants wishing to audit courses are subject to the same regulations, including tuition, as those taking courses for credit. Special Students wishing to con -tinue or to resume studies as a Special Student need file only the application form and fee to be considered. Faxed applications will not be reviewed.The Office of Admissions notifies all applicants of admissions decisions. If the applicant is admitted, he/she must arrange to pay tuition and complete the registra -tion process at the Student Services Center, Room 11-120. These transactions must be completed as soon as possible.Current course offerings are viewable online at https://www.sodocs.net/doc/84782503.html,/catalog/.
APPLICATION PROCEDURE
A person who does not possess an undergraduate degree will be considered an Undergraduate Special Student. A former MIT student who has withdrawn for any reason and wishes to be readmitted should apply to Counseling and Support Services (after a first required withdrawal) or the Committee on Academic Performance (after a second required withdrawal). Undergraduate Special Students are limited to two terms. Special Student status is a guest status only and not a means to an undergraduate degree at MIT.
A candidate for admission as a Special Student who holds an undergraduate degree will be considered a Graduate Special Student. Graduate Special Students are limited to three terms. An applicant who was formerly enrolled at MIT as a degree-oriented graduate student and who has not subsequently obtained a degree must have the approval of the Office of the Dean of the Graduate School to be considered for admission as a Special Student. Similar approval is required if the applicant has received a formal warning or disqualification for poor academic performance in an MIT department other than the one to which the applicant seeks admission. NOTE: The Department of Mechanical Engineering will not accept a Special Student application from anyone who has been denied admission to their graduate degree program.
Qualifications for admission as a Special Student are not appreciably different from those expected of a regular student. The department to which the student applies will evaluate an applicant’s qualifications for the specific course(s) desired. Prior instructor approval does not ensure admission. If an individual is applying to take subjects in more than one department, approval of the Registration Officer in each department is required. Final approval is at the discretion of the Office of Admissions. All admitted Special Students must receive satisfactory grades in order to reapply for future terms.
For former MIT students, any course grade you receive as a Special Student will contribute to your cumulative MIT grade-point average. Visiting Students cannot register without changing their status.
QUALIFICATIONS
S P E C I A L S T U D E N T I N F O R M A T I O N S H E E T
MIT EMPLOYEES
MIT employees may be eligible for reimbursement of one MIT course per term through the Tuition Assistance Plan. Employees must adhere to the
same application procedures, deadlines, and qualifications as all Special Students. Once they are admitted by the Office of Admissions as a Special Student, employees must submit additional information to the Benefits Office in order to obtain a tuition deferment prior to the start of class. If students suc-cessfully complete their course by earning a minimum final grade of C- or better for an undergraduate course or B- or better for a graduate course, and if they remain eligible to participate in the Tuition Assistance Plan through the last day of their course, their student account will be credited with the amount of the tuition (a prorated amount for part-time employees) by an internal transfer of funds. Please note that auditing a course is not permitted under the Tuition Assistance Plan.
Further information is provided in the Employee Benefits section of the Human Resources website at https://www.sodocs.net/doc/84782503.html,/benefits/education/ta/index.html.
A candidate for admission as a Special Student who is employed by MIT must obtain the approval of his/her supervisor. The supervisor must indicate approv-al by signing in Section 9 of the application form. Signature approval must be obtained prior to submitting the application to the Office of Admissions. INTERNATIONAL STUDENTS
A student who is neither a United States citizen nor a United States Permanent Resident is considered an International Student.
In addition to the academic documentation required for admission as a Special Student, international applicants must submit a photocopy of their official TOEFL (Test of English as a Foreign Language) or IELTS (International English Language Testing System) score. The minimum required scores are 90 on the TOEFL internet-based test and 7 on the IELTS. Some departments may have higher score requirements; please visit the relevant department's website for further information regarding minimum score requirements. A completion certificate from an English language program may be submitted in lieu of these test scores. All transcripts must be certified and officially translated into English.
International applicants must submit a completed Financial Certification Form with their application. On the Financial Certification Form, the applicant must provide evidence of their ability to meet all financial obligations of study at MIT, including tuition and living expenses. Please note that living expenses for married students are substantially higher. The form 1-20 or DS 2019 will not be issued for subject registration of less than 36 units. Most subjects at MIT are either 9 or 12 units each. Full-time tuition (covering 36 units or more) for one semester in 2010-2011 is $19,470. (Different tuition rates apply for classes taken in the Sloan School of Management. See below for more information about per-unit charges.)
An international student who holds a student visa at another university or any non-resident visa holder should contact the International Students’ Office for information on transfer or change of visa status procedures. International students living outside of the United States are not p ermitted to apply for the summer session. International students are not permitted to cross-register at Harvard University.
FEES
Those applying for Special Student status for the first time pay a $75 application fee, which will cover two sequential terms. Otherwise, a new fee will be required for each term. The tuition fee for Special Students in the 2010-2011 Fall and Spring terms is $605 per unit, with a minimum charge of $5,445 and a maximum charge of $19,470. For Special Students who are employees of MIT and dependents of MIT employees, regular (undergraduate or graduate) MIT students and dependents of regular students, the minimum tuition is $3,630. The fee for Special Students in the Sloan School of Management is $1,062 per unit with a minimum charge of $9,558 and a maximum charge of $34,650.
Special Students are charged a prorated fee for any course dropped after registration day and are charged in full for any course added. A Student Life fee of $136 is required of all Special Students who are not MIT employees, employee dependents, MIT students or student dependents. Special Students carrying 27 or more units, or Special Students on a J1 visa regardless of the number of units, are also required to have health insurance. Special Students with comparable insurance may submit a waiver to the Student Health Plan office for the Student Extended Insurance Plan via the on-line waiver system (see "Medical Care" section below).
MEDICAL CARE
Massachusetts state law requires Special Students carrying 27 or more units, or Special Students on a J1 visa regardless of the number of units, to have health insurance. Students paying tuition to MIT are automatically enrolled in the Student Extended Insurance Plan, which meets the state health insurance require-ment. The fee for the Student Extended Insurance Plan is $1,656 for the 09-10 academic year ($690 for the Fall term only; $966 for the Spring term only).
Students who have other insurance that meets Massachusetts requirements can ask to waive mandatory enrollment in the MIT Student Extended Insurance Plan. For further information visit the Student Health Plan website at https://www.sodocs.net/doc/84782503.html,/healthplans/student/index.html, or contact the Student Health Plan office at 617-253-4371 or stuplan@https://www.sodocs.net/doc/84782503.html,.
All Special Students must show evidence of required inoculations and submit a Medical Report Form to the MIT Medical Department. Special Students with a chronic medical condition are urged to identify their condition on the Medical Report Form. The Medical Report Form must be submitted to the MIT Medical Department prior to Registration Day. For further information or questions on the Medical Report Form, contact medrpt@https://www.sodocs.net/doc/84782503.html,.
4 Biographical information
Applicant’s legal name __________________________________________________________________________________________________________
Last/Family/Surname
First/Given name
Middle
Suffix (Jr., III, etc.)
Applicant’s preferred first name___________________________________ o Female o Male
Date of birth __________________________
Place of birth_________________________________________________
Month/Day/Year
City/State or province/Country
Office of Admissions
Massachusetts Institute of Technology Room 3-103 (S)
77 Massachusetts Avenue Cambridge, MA 02139-4307Phone (617) 253-2917mitspecial@https://www.sodocs.net/doc/84782503.html,
This is the application to study at MIT as a non-matriculating, non-degree ori-ented student. This form must be submitted each semester. This application plus supporting documents should be submitted by: U.S. Citizens and International
Permanent Residents Students Fall Term August 1 June 1Spring Term January 1 November 1Summer Term
May 1
March 1
5o Fall Term 20____
o Spring Term 20____
o Summer Term 20____
3 Have you ever applied to MIT before? o Yes
o No
If yes, select appropriate boxes and indicate term and year:
o Undergraduate _________________
o Graduate ______________________
o Special ________________________
o Transfer _______________________
Did you enroll? o Yes
o No
If you enrolled, have you ever withdrawn from MIT? o Ye s
o
No
1
Special Student status is for one term only and is contingent on approval of the specified course(s) by both the relevant department(s) and the Office of Admissions.
? I understand that admission as a Special Student does not imply present or future admission to MIT as a degree candidate.? I understand that prior instructor approval does not ensure admission.
? I understand that final approval is at the discretion of the Office of Admissions
? I understand that as a Special Student applicant, I may not attend classes until I have been notified by the Office of Admissions.
? I understand that any course changes after admission has been granted will require additional approval by the Office of Admissions.
? I understand that Special Students are charged a prorated fee for any course dropped after registration day and are charged in full for any course added.
?
I have completed all applicable spaces on this application and I affirm their accuracy. I understand that any misrepresentation of facts on this a pplication may be cause for refusal or cancellation of admission as a Special Student.
Signature Date
Addresses
Mailing address (if different from your home address)
Street address
City State or province ZIP or postal code
( )
Country
Area or country code
Telephone
? If your mailing address differs from your home address, mailing address
is valid from:_______________through _______________
beginning date ending date Email address
In connection with its Affirmative Action Plan, the Massachusetts Institute of Technology guarantees equal opportunity in education to students of all racial and
ethnic backgrounds. I consider myself to belong to the following ethnic group(s) (check all that apply):1.) Are you Hispanic or Latino? Yes, Hispanic or Latino (including Spain) No
Which best describes your background? Central America Cuba Mexico Puerto Rico South America Spain
Other__________________________
2.) Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member. American Indian or Alaska Native (including all Original Peoples of the Americas)
Which best describes your background? Alaska Native Chippewa Choctaw Cherokee Navajo Sioux
Other__________________________ Are you registered?
No Asian (including Indian subcontinent and Philippines) Which best describes your background? China India Japan Korea Pakistan Philippines Vietnam Other East Asian________________________ Other Indian Subcontinent________________________
Other Southeast Asian___________________________
Black or African American (including Africa and Caribbean) Which best describes your background? African American Caribbean African
Other__________________________
Native Hawaiian or Other Pacific Islander (Original Peoples) Which best describes your background? Guam Hawaii Samoa
Other Pacific Islands (excluding Philippines)_____________________ White (including Middle Eastern)
Which best describes your background? Europe Middle East
__________________________
7Optional (U.S. citizens and permanent residents only)
Non-U.S. Citizen/Non-U.S. Permanent Resident
Country of citizenship
_______________________________
Visa Type (if applicable) _____________________________
(F-1, J-1, etc.)
Company Supervisor
City
State
Country
If you are employed by MIT, please specify:
o Staff
o Non-Staff
o Lincoln
o
Other
Department
Supervisor name, title, and MIT extension (please print) Supervisor signature of approval
Date
List any technical institutes, junior colleges, four-year colleges or universities you have attended, or are currently attending (including MIT).
Name Date entered City
State Date departed ZIP /Postcode
Country
Degree
Name Date entered City
State Date departed ZIP /Postcode
Country
Degree
Please give the name of your employer, if other than MIT.
Date of birth ( Month / Day / Year )
Please list the courses you would like to enroll in. MIT employees are eligible to receive Tuition Assistance for one course per term.
What is your objective in applying for admission as a Special Student? Please be specific. (Please attach a separate sheet of paper if necessary.)
Course number Course title Number of units (e.g., 6, 9, 12, 15)
Course number Course title Number of units (e.g., 6, 9, 12, 15)
Course number Course title Number of units (e.g., 6, 9, 12, 15)
Course number Course title Number of units (e.g., 6, 9, 12, 15)
Course number Course title Number of units (e.g., 6, 9, 12, 15)
Please indicate your TOEFL or IELTS score and date of test.
Test score Date of test
CHECKLIST
o Completed Application Form
o Official Transcript(s) in English
o Evaluation Form
o$75 non-refundable application fee (U.S. dollars)
Use a check or money order payable to MIT Office of Admissions
o$40 late fee, if applicable
International Students
o Financial Certification Form
o Photocopy of Permanent Resident or Green Card (if applicable)
o TOEFL or IELTS score (photocopy of the official score report)
Mail application packet to:
The Office of Admissions
Massachusetts Institute of Technology
Room 3-103(S)
77 Massachusetts Avenue
Cambridge, MA 02139-4307
The MIT Bulletin
For detailed course listings and degree requirements consult The MIT Bulletin (Course and Degree Catalogue), which you can order through the MIT Press Bookstore by calling (617) 253-5249. They can also be ordered online at https://www.sodocs.net/doc/84782503.html,/bookstore/bulletin.html. The cost is $5.00 plus shipping, and it is available for delivery to anywhere in the world.
Course descriptions are also available on the Web: https://www.sodocs.net/doc/84782503.html,/catalogue/.
MIT’s policy of nondiscrimination
The Massachusetts Institute of Technology is committed to the principle of equal opportunity in education and employment. The Institute does not discrimi-nate against individuals on the basis of race, color, sex, sexual orientation, religion, disability, age, veteran status, ancestry, or national or ethnic origin in the administration of its educational policies, admissions policies, employment policies, scholarship and loan programs, and other Institute-administered programs and activities, but may favor U.S. citizens or residents in admissions and financial aid.*
The Vice President for Human Resources is designated as the Institute’s Equal Opportunity Officer and Title IX Coordinator. Inquiries concerning the-Insti-tute’s policies, compliance with applicable laws, statutes, and regulations (such as Title VI, Title IX, and Section 504), and complaints may be-directed to Laura Avakian, Vice President for Human Resources, Room E19-239N, (617) 253-6512 or to Philip Lima, Coordinator of Staff Diversity Initiatives, Room
E19-215, (617) 253-1594. Inquiries about the laws and about compliance may also be directed to the Assistant Secretary for Civil-Rights, U.S. Department of Education.
* T he ROTC programs located on the MIT campus are operated under Department of Defense policies and regulations, and do not comply fully with MIT’s policy of nondiscrimination with regard to sexual orientation. On the recommendation of the Faculty, MIT is working to develop a modified on-campus ROTC program open to all MIT students.
MIT’s use of information
MIT is committed to protecting the individual privacy of applicants and students by restricting the use of all collected information as specified by Institute policies. In accordance with these policies, the information on this application may be used by MIT officials only for appropriate administrative and research purposes.
Safety and security
The Safety, Security, and Crime Prevention Handbook for MIT, a comprehensive overview of the MIT Campus Police Department, its services, Institute safety and security policies and procedures, and campus crime statistics, is available upon request from Campus Police headquarters at-W31-215, 77 Massachusetts Avenue, Cambridge, MA 02139-4307 or on the Web at https://www.sodocs.net/doc/84782503.html,/cp/www/safety_handbook_03.pdf.
S P E C I A L S T U D E N T E V A L U A T I O N F O R M
Under the Family Educational Rights and Privacy Act (Buckley Amendment), a student enrolled at MIT has access to his or her educational records. To the Applicant: Sign your name below only if you agree to voluntarily waive your right of access to review this recommendation.
Applicant Signature Date
Name of Applicant
College Attending, or Last Attended To the Applicant:
This form should be completed by a professor or by someone in a supervisory capacity under whom you are employed.
To the Endorser:
We shall be grateful if you will give us your
evaluation of this applicant. Please use examples where relevant.
Name Address Position
Length of time acquainted with applicant Signature of evaluator
Date
Please return directly to Special Student Admissions, Building 3-103(S), MIT
Office of Admissions
Massachusetts Institute of Technology Room 3-103 (S)
77 Massachusetts Avenue Cambridge, MA 02139-4307Phone (617) 253-2917