RCIP - Application Form: Exchange Student

Please complete the following application form for exchange student. Once you are finished, you can click the 'submit' button to send the form.

Items with an * indicate a required field.

Signature of Applicant *
(First and Last Name)
Date *
STUDENT CERTIFICATION OF INFORMATION PROVIDED This is to certify that all of the information on this form is accurate to the best of my knowledge. I will be responsible for all tuition, fees, and living expenses while studying at Ball State University. I understand that any falsification or fraud provided on this application may result in serious consequences, including withdrawal from or non-admission to Ball State University. A $40.00 charge will be assessed if it is necessary to deliver the I-20/DS-2019 a second time via FedEx Courier.
Please indicate your home institution (or exchange program name) *
Choose your academic level *
How long do you plan to stay? *
Are you applying for the Intensive English Institute? *	Yes No
Entry date: *
Desired major 1 *
Desired major 2
Last Name *
First Name *
Middle Name
Permanent address(Number and Street, City, State/Province, Postal Code, Country) *
Current mailing address(Number and Street, City, State/Province, Postal Code, Country) *
Phone *
Fax *
Email *
Date of birth *
Place of birth(City, Country) *
Citizenship *
Place of legal residence *
Sex *
Marital Status *
Have you ever been convicted of a felony? *	Yes No
If yes, please send a letter of explanation to intadmit@bsu.edu
Members of your family 1
If members of your family will accompany you, please complete the following information for each person(1.Name(family, first) 2.Place of birth(city and country) 3.Date of birth 4.Citizenship 5.Relationship to applicant)
Members of your family 2
If members of your family will accompany you, please complete the following information for each person(1.Name(family, first) 2.Place of birth(city and country) 3.Date of birth 4.Citizenship 5.Relationship to applicant)
Members of your family 3
If members of your family will accompany you, please complete the following information for each person(1.Name(family, first) 2.Place of birth(city and country) 3.Date of birth 4.Citizenship 5.Relationship to applicant)
Parents or guardians(1.Father's full name 2.Mother's full name) *
Complete Educational Background (Secondary 1) [institute name, date entered, date completed, degree earned] *
Attach to this application certified copies of academic certificates and transcripts in English and the native language for ALL institutions you have attended from the time you entered secondary school 13th year of age. Failure to list all institutions could result in dismissal. Provide complete details on a separate sheet of paper if necessary.
Complete Educational Background (Secondary 2) [institute name, date entered, date completed, degree earned] *
Attach to this application certified copies of academic certificates and transcripts in English and the native language for ALL institutions you have attended from the time you entered secondary school 13th year of age. Failure to list all institutions could result in dismissal. Provide complete details on a separate sheet of paper if necessary.
Complete Educational Background (University 1) [institute name, date entered, date completed, degree earned] *
Attach to this application certified copies of academic certificates and transcripts in English and the native language for ALL institutions you have attended from the time you entered secondary school 13th year of age. Failure to list all institutions could result in dismissal. Provide complete details on a separate sheet of paper if necessary.
Complete Educational Background (University 2) [institute name, date entered, date completed, degree earned] *
Attach to this application certified copies of academic certificates and transcripts in English and the native language for ALL institutions you have attended from the time you entered secondary school 13th year of age. Failure to list all institutions could result in dismissal. Provide complete details on a separate sheet of paper if necessary.
Do you wish to be considered for a graduate assistantship? *
If yes, name the graduate or university department you intend to apply to for an assistantship:
To receive full consideration for graduate assistantship, you must meet the following application deadlines:Fall Semester, January 1;Spring Semester, July 1
TOEFL score, Date taken/to be taken(Paper Test, Computer
Test, or Internet Test)
The minimum TOEFL requirement for full admission is 550(213 CBT / 79 IBT). Student with TOEFL score below 550 are eligible to attend English Language Programs on the BSU campus. Please contact the International Admission Office for details. The TOEFL, SAT, GRE and GMAT code for BSU is 1051.
How did you learn of Ball State University: *
Please list Ball State graduates or current students you know:
Would you like a current Ball State student to contact you? *
If yes, how?
If you have you applied to other universities in the U.S., please indicate their names. *
Name of your financial sponsor and Relationship to you: *
Financial : In order to enroll at Ball State University, you must provide evidence of financial support for your educational and living expenses for the length of your stay. Sponsorship: Indicate the source of financial support for your education and attach an original letter from your sponsor's bank verifying the amount and availability of funds.
Address of sponsor: *