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Programs
	
Calendar	and	Tuition	
Session/Dates	 Weeks	 AEP/ELP	Intensive	 ELP	Each	Course	 Elective	Courses	
Spring	2016		
January	15	–	May	9	(holidays	March	14-18)	
15	 $4995	 $1250/*$1105	 $585/*$500/**$400	
Summer	I	2016			
May	27	–	August	8	(holiday	July	4)	
10	 $3350	 $840/*$745	 $585/*$500/**$400	
Summer	II	2016	«	AEP	only	
July	6	–	August	8	
4.5	 $1540	 --------	 ----------	
Summer	II	2016	««	ELP	only	
July	8	–	August	12	
5	 $2850	 --------	 --------	
Fall	2016	
Aug	19	–	Dec	6	(holidays	Sep	5	and	Nov	23-25)	
15	 $4995	 $1250/*$1105	 $585/*$500/**$400	
	
*	Discounted	tuition	for	UT	affiliates	(up	to	3	classes)	**Discounted	tuition	for	AEP/ELP	intensive	students	
			«	4.5-week	session	for	AEP	only;	this	is	an	intensive	session	designed	for	graduate	and	undergraduate	students	admitted	to	a	degree	program	at	
UT	or	another	US	university	for	the	upcoming	Fall	semester.	Classes	in	Listening/Speaking	and	Reading/Writing	meet	Mon	-	Fri,	1:00-5:00pm.	
			««	5-week	session	for	ELP	only;	this	is	a	super-intensive	session	with	23	hours	of	class	per	week.		
	
	
Estimated	Expenses	for	Intensive	English	
Your	financial	support	document	must	show	at	least	the	total	amount	estimated	
for	the	duration	of	your	study.	
	 	 	 	 			15	weeks	 10	weeks	 	 4.5	weeks	
Tuition	 	 	 			$4995	 	 $3350	 	 $1540	
Health	Insurance			 			$		906	 	 $		548		 	 $		548		
Room	and	Board	 			$5830	 	 $4375	 	 $2915	
Books	and	Supplies	 			$		300	 	 $		300	 	 $		150	
Total		 	 	 			$12,031		 $8573	 	 $5153	 	
	 	 	 	 	 	 	 	 				
*Health	insurance	through	The	University	of	Texas	is	required	of	all	students	on	
F	or	J	visas,	unless	they	provide	proof	of	a	private	policy	that	meets	or	exceeds	
university	requirements.	
	
Refund	Policy:	A	full	refund	is	available	only	prior	to	first	day	of	class;	all	
refunds	after	classes	begin	are	pro-rated.	Details	will	be	provided	during	registration.	SEVIS	fees,	express	mail	charges,	and	tuition	deposits	are	
non-refundable	and	are	applicable	only	to	the	first	semester	applied	for.	
Policy	on	Late	Students:	The	last	day	to	late	register	is	the	Wednesday	of	registration	week.		After	that	Wednesday,	new	students	will	be	allowed	
to	enroll	only	as	space	permits;	if	our	classes	are	full,	we	will	facilitate	student	transfers	to	other	intensive	English	programs.		 	
	
Please	note	that	dates,	program	costs,	and	estimates	of	other	costs	are	subject	to	change	without	notice.	
	
To	Apply		
1. Complete	the	application	form.	New	students	should	apply	a	minimum	of	60	days	in	advance.	
2. Applying	to	AEP?	Send	a	transcript	or	diploma	of	your	completed	undergraduate	degree.	
3. NEW	AEP/ELP	INTENSIVE	student	needing	an	I-20	(or	DS-2019)?		Include		
• a	copy	of	the	photo	page	of	your	passport,	
• a	financial	guarantee	statement	(usually,	a	personal/family	bank	statement),	and		
• $350	USD		(Includes	SEVIS	fee	of	$200,	express	mail	&	document	processing	fee	of	$50,	and	tuition	deposit	of	$100,	non-refundable.)	
4.					PART-TIME	or	TRANSFER	student?	Send	a	$100	USD	tuition	deposit	(non-refundable).	
	
Send	airmail	or	regular	domestic	mail	to:	 	 	 Send	EXPRESS	mail	to	(or	visit	us	in	person	at):	
ESL	Services	 	 	 	 	 	 	 	 ESL	Services	
International	Office	 	 	 	 	 	 	 International	Office	
PO	Box	A,	University	Station	 	 	 	 	 	 2400	Nueces	St,	Suite	B		 	 	 	 	
Austin,	TX	 78713-8901	 	 	 	 	 	 Austin,	TX	 78705	
Email	the	PDF	application	(with	any	email	attachments)	to:	esl@austin.utexas.edu,	or	fax	materials	to	us	at:	512-475-6810.	
	Intensive	tuition	includes			
Ÿ	placement	testing		
Ÿ	orientation	program	
Ÿ	learner	management	system	(LMS)	for	classes	 	
Ÿ	UT	computer	labs	&	email						
Ÿ	UT	libraries	
Ÿ	University	ID	 	
Ÿ	immigration	advising	 	
Ÿ	UT	application	information	
Ÿ	discounts	on	test	preparation	classes	
Ÿ	weekly	activity	newsletter	
Ÿ	PALS	conversation	partner	program	 	 	
Ÿ	social	activities	&	trips	
Ÿ	Institutional	TOEFL	Examination	(for	students	in	good	standing)	
			
Tuition	does	NOT	include	health	insurance	and	health	center	fees,	
room	and	board	(housing	and	food	costs)	or	books	and	supplies.		
The	figures	to	the	left	are	provided	for	your	information	and	are	
estimated	costs.		
Academic	English	Program	(AEP)	
For	ESL	students	who	already	have	at	least	a	bachelor’s	degree	and	
who	plan	to	enroll	in	a	master’s	or	Ph.D.	program.	
English	Language	Program	(ELP)	
For	ESL	students	of	all	levels:	beginner	to	advanced,	(intensive	
and	part-time	options.)
2
	
	
	
	
	
	
	
1)	PERSONAL	INFORMATION:			(Areas	in	gray	are	used	for	immigration	documents	and	must	be	filled	in	completely.)	
	
Name:	____________________________________	 			_________________________________	 _____________________________________	
	Family	Name	(as	on	passport)	 	 	 			First	Name		(as	on	passport)	 	 	 Middle	Name	(as	on	passport)	
	
Gender:						❒	male			❒	female	 	 	 Date	of	Birth:	_____/_____/________	 Country	of	Birth:	_______________________				
				 	 	 	 	 	 	 	 	 	 							month	/	day		/		year	
City	of	Birth:	_____________________	 Country	of	Citizenship:	_______________________	
												 				
	 	 	 	 	 	
E-mail	address:	_____________________________________________________________	
	
Permanent	Mailing	Address	(your	country):							 	 	 								Current	Mailing	Address	(Immigration	documents	will	be	sent	here):	
	
_________________________________________________	 	 ____________________________________________________	
Number	and	Street	 	 	 	 Apt.	#	 	 	 	 Number	and	Street	 	 	 	 Apt.	#	
_________________________________________________	 	 ____________________________________________________	
City	 	 	 	 	 	 	 State		 	 	 	 City	 	 	 	 	 	 	 State		
_________________________________________________	 	 ____________________________________________________	
Country	 	 	 	 	 	 Postal	Code		 	 	 Country	 	 	 	 	 	 Postal	Code	
_________________________________________________	 	 ____________________________________________________	
Telephone	Number		 	 	 	 	 	 	 	 	 Telephone	Number	
	
	
	
	
	 	 Please	note	that	all	course	times	are	dependent	on	room	availability	and	are	subject	to	change.	
	
7)	US	VISA	INFORMATION:		
A.		If	you	are	in	the	US	now,	what	kind	of	visa	do	you	have?		 ❒		F-1	 ❒		J-1		 ❒		Other	(please	specify):	________		
B.		Do	you	have	a	SEVIS	ID	number?	❒	Yes				❒	No		If	yes,	please	write	your	SEVIS	ID	here:	_____________________________		
C.		If	you	are	transferring	from	another	school	in	the	US,	please	provide	the	school	name	and	contact	information:		
					School	name:______________________________											Telephone:	_______________________										Fax:	____________________________	
	
If	you	have	dependents	who	need	immigration	documents,	please	add	their	information	below	(attach	additional	pages	if	needed):	
Name		 	 	 	 	 	 	 				Date	of	Birth	(month/day/year)									Country	of	birth			Country	of	citizenship		 							Relationship	to	student																															
	_____________________________________	 				______________	 	 								____________			____________	 						_______________
2)	PROGRAM			 	 3)	SESSION		
(Dates	on	p.	1)	
Weeks	
❒	 AEP			
(Intensive	Only)	
	 ❒	 Spring	2016	 15	
❒	 ELP	intensive		 	 ❒	 Summer	2016		 10	
❒	 ELP	part	time	 	 ❒	 Summer	2016	
–	AEP	ONLY	
4.5	
	 	 	 ❒	 Summer	2016	
–	ELP	ONLY	
5	
	 	 	 ❒	 Fall	2016	 15	
4)	ELECTIVE	COURSES	(OPTIONAL):		
6-week	courses	/	TTH	mornings.	Students	can	take	a	
maximum	of	2	during	Fall	or	Spring	and	one	during	
the	10-week	Summer	program.	
	 5)	ELP	part-time	applicants	only:			
You	may	take	a	maximum	of	three	core	courses,	or	two	
core	courses	and	two	elective	courses.		
Part-time	students	are	not	eligible	for	student	visas.			
	 6)	I-20:	Do	you	need	a	Form	I-
20?												❒	Yes				❒	No	
Must	show	enough	financial	
support	for	requested	duration.	
See	p.	1	Estimated	Expenses.	
	 Course	 Minimum	
Proficiency	
	 	 Course	 Days	 Times	 	 If	yes,	choose	one.	
❒	 TOEFL	Preparation	 Intermediate	 	 ❒	 Writing	 MWF	 9-10:30	 	 ❒	 1	session	
❒	 IELTS	Preparation	 Intermediate	 	 ❒	 Grammar	 MWF	 11-12:30	 	 ❒	 2	sessions	
❒	 Pronunciation	 High	Beginner	 	 ❒	 Listening/Speaking	 MWF	 2-3:30	 	 ❒	 1	year	
❒	 GRE	Preparation	 High	intermediate	 	 ❒	 Reading	and	Discussion	 TTH	 1-3:15	 	 	
Application	for	ESL	Programs:	Academic	English	Program	(AEP)	and	English	Language	Program	(ELP)	
awer		
	
Intensive	Study:	You	will	have	4	core	courses:	Writing,	Grammar	and	Idioms,	
Listening/Speaking,	Reading	and	Discussion.	
Part-Time	Study:	Maximum	of	3	core	courses,	or	2	core	and	2	elective	
courses.	
Proficiency	Requirement:	ELP	offers	instruction	to	adults	at	all	levels.		AEP	
requires	at	least	low-intermediate	proficiency	based	on	our	placement	test	
or	TOEFL	PBT	of	425+	(113+	CBT/38+	iBT)	AND	a	Bachelor’s	(4-year)	degree.		
Students	applying	to	AEP	will	be	placed	in	ELP	if	they	do	not	meet	these	
minimum	qualifications.
3
	
8)	EDUCATION	INFORMATION:	
What	is	your	highest	education	degree?		 	❒	High	School			❒	Bachelor’s/Undergraduate	(4-year)			❒	Master’s		 ❒	Ph.D.	
Graduation	year:		________		Institution:	_____________________________________		Field	of	study:	__________________________	
Do	you	already	have	a	UT	EID?		If	yes,	write	it	here:	_______________________	
If	you	have	taken	the	TOEFL	or	IELTS	exam,	write	your	score	here:	_________								Date	of	test:		__________	
	
	
9)	FINANCIAL	GUARANTEE	STATEMENT:	(F-1	or	J-1	Students	Only)	
Person	who	is	financially	responsible:	 ❒	Applicant					❒	Parents/Family	 ❒	Sponsor	
If	you	will	be	funded	by	family	or	a	sponsor,	please	write	that	information	below.	
	
__________________________________________________________	
Name	of	financially-responsible	party	 	 	 	 	
__________________________________________________________	
Address	
__________________________________________________________	 				
	
__________________________					_____________________________						
Telephone	 	 	 	 			Fax	 	 	 	 	 	
	 		
	
By	signing	below,	I	certify	that	funds	are	available	for	the	total	expenses,	and	will	be	provided	as	specified.	
	
Parent	or	Sponsor	Signature:	____________________________________________	 	 	 Date	__________________	
	
10)	CERTIFICATION:	
All	applicants	complete:	
❒		I	have	read	and	completed	this	form,	and	I	certify	that	the	information	provided	is	accurate	and	complete.	
❒		I	understand	that	I	am	responsible	for	arranging	my	own	housing	and	transportation	from	the	airport.	
❒		I	understand	that	admission	to	ESL	Services	is	not	a	guarantee	of	admission	to	any	other	program	at	The	University	of	Texas	at	Austin.	
	
AEP	applicants	complete:	
❒	I	am	enclosing	a	copy	of	a	diploma/transcript	which	shows	I	have	completed	at	least	a	Bachelor’s/Undergraduate	(4-year)	degree.		
❒	I	understand	that	if	I	do	not	meet	minimum	qualifications	for	AEP	admission,	I	will	be	placed	in	ELP.	 	
	
_____________________________________________________________	 	 ___________________	
Applicant’s	signature	 	 	 	 	 	 	 	 	 	 Date			
	
11)	PAYMENT	INFORMATION:	
Payment	in	full	is	due	at	registration.		Tuition	and	other	fees	may	be	paid	with	MasterCard,	Visa,	US	currency,	a	bank	draft,	or	money	order	in	US	
dollars,	traveler’s	checks,	or	a	personal	check	from	a	US	bank.			
	
New	students	who	will	apply	for	an	F-1	or	J-1	visa	must	pay	$350	USD	(non-refundable).	This	payment	covers	your	$200	SEVIS	fee,	express	mail	
&	document	processing	fee	of	$50,	and	a	$100	tuition	deposit.	The	SEVIS	fee	is	mandatory	for	all	new	students	applying	for	an	initial	F-1	or	J-1	
visa.		It	is	used	by	the	Department	of	Homeland	Security	to	maintain	the	SEVIS	(Student	&	Exchange	Visitor	Information	System)	database.	
	
All	other	applicants	must	pay	a	non-refundable	tuition	deposit	of	$100	USD,	which	will	be	applied	to	the	cost	of	the	program	upon	admission.		
	
❒		I	am	enclosing	or	authorizing	charges	of	$350	for	SEVIS	fee	payment,	express	mail	&	document	processing,	and	tuition	deposit.	
					(I	do	need	an	F-1	or	J-1	visa).	
	
❒		I	am	enclosing	or	authorizing	charges	of	$100	for	my	tuition	deposit.	
						(I	do	not	need	an	F-1	or	J-1	visa,	or	I	am	transferring	from	another	school	in	the	US).	
	
Payment	type:		 ❒	Bank	draft/money	order		 ❒	Traveler’s	check/personal	check	(payable	to	“The	University	of	Texas	at	Austin”)
	 	 	 ❒	MasterCard	 	 	 	 ❒	Visa	
If	paying	by	credit	card,	please	complete:		 	
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	
	 						Card	Number	 	 	 	 	 	 	 	 	 	 		Expiration	(month/year)					CVV	(security)	code	
	
Printed	name	of	cardholder:		____________________________________		Authorized	signature:	_________________________________________	
	
After	receiving	ALL	required	information	listed	above,	your	application	will	be	processed	
and	applicable	immigration	documents	will	be	sent	to	you.	
	
	 	 	 	 	 	 Last	revised	10/29/2015	
United	States	Customs	and	Immigration	Services	requires	that	students	
give	evidence	that	they	are	able	to	pay	all	tuition,	fees,	and	living	
expenses	while	studying	in	the	US	before	a	school	issues	a	Form	I-20.		
Attach	a	letter	of	financial	guarantee	from	the	bank	of	the	responsible	
party	showing	sufficient	funds	are	available	for	the	total	expenses	(See	
Estimated	Expenses	on	p.	1).	Additional	funding	is	required	when	
dependents	accompany	the	student.

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University of Texas at Austin Application 2016

  • 1. 1 Programs Calendar and Tuition Session/Dates Weeks AEP/ELP Intensive ELP Each Course Elective Courses Spring 2016 January 15 – May 9 (holidays March 14-18) 15 $4995 $1250/*$1105 $585/*$500/**$400 Summer I 2016 May 27 – August 8 (holiday July 4) 10 $3350 $840/*$745 $585/*$500/**$400 Summer II 2016 « AEP only July 6 – August 8 4.5 $1540 -------- ---------- Summer II 2016 «« ELP only July 8 – August 12 5 $2850 -------- -------- Fall 2016 Aug 19 – Dec 6 (holidays Sep 5 and Nov 23-25) 15 $4995 $1250/*$1105 $585/*$500/**$400 * Discounted tuition for UT affiliates (up to 3 classes) **Discounted tuition for AEP/ELP intensive students « 4.5-week session for AEP only; this is an intensive session designed for graduate and undergraduate students admitted to a degree program at UT or another US university for the upcoming Fall semester. Classes in Listening/Speaking and Reading/Writing meet Mon - Fri, 1:00-5:00pm. «« 5-week session for ELP only; this is a super-intensive session with 23 hours of class per week. Estimated Expenses for Intensive English Your financial support document must show at least the total amount estimated for the duration of your study. 15 weeks 10 weeks 4.5 weeks Tuition $4995 $3350 $1540 Health Insurance $ 906 $ 548 $ 548 Room and Board $5830 $4375 $2915 Books and Supplies $ 300 $ 300 $ 150 Total $12,031 $8573 $5153 *Health insurance through The University of Texas is required of all students on F or J visas, unless they provide proof of a private policy that meets or exceeds university requirements. Refund Policy: A full refund is available only prior to first day of class; all refunds after classes begin are pro-rated. Details will be provided during registration. SEVIS fees, express mail charges, and tuition deposits are non-refundable and are applicable only to the first semester applied for. Policy on Late Students: The last day to late register is the Wednesday of registration week. After that Wednesday, new students will be allowed to enroll only as space permits; if our classes are full, we will facilitate student transfers to other intensive English programs. Please note that dates, program costs, and estimates of other costs are subject to change without notice. To Apply 1. Complete the application form. New students should apply a minimum of 60 days in advance. 2. Applying to AEP? Send a transcript or diploma of your completed undergraduate degree. 3. NEW AEP/ELP INTENSIVE student needing an I-20 (or DS-2019)? Include • a copy of the photo page of your passport, • a financial guarantee statement (usually, a personal/family bank statement), and • $350 USD (Includes SEVIS fee of $200, express mail & document processing fee of $50, and tuition deposit of $100, non-refundable.) 4. PART-TIME or TRANSFER student? Send a $100 USD tuition deposit (non-refundable). Send airmail or regular domestic mail to: Send EXPRESS mail to (or visit us in person at): ESL Services ESL Services International Office International Office PO Box A, University Station 2400 Nueces St, Suite B Austin, TX 78713-8901 Austin, TX 78705 Email the PDF application (with any email attachments) to: esl@austin.utexas.edu, or fax materials to us at: 512-475-6810. Intensive tuition includes Ÿ placement testing Ÿ orientation program Ÿ learner management system (LMS) for classes Ÿ UT computer labs & email Ÿ UT libraries Ÿ University ID Ÿ immigration advising Ÿ UT application information Ÿ discounts on test preparation classes Ÿ weekly activity newsletter Ÿ PALS conversation partner program Ÿ social activities & trips Ÿ Institutional TOEFL Examination (for students in good standing) Tuition does NOT include health insurance and health center fees, room and board (housing and food costs) or books and supplies. The figures to the left are provided for your information and are estimated costs. Academic English Program (AEP) For ESL students who already have at least a bachelor’s degree and who plan to enroll in a master’s or Ph.D. program. English Language Program (ELP) For ESL students of all levels: beginner to advanced, (intensive and part-time options.)
  • 2. 2 1) PERSONAL INFORMATION: (Areas in gray are used for immigration documents and must be filled in completely.) Name: ____________________________________ _________________________________ _____________________________________ Family Name (as on passport) First Name (as on passport) Middle Name (as on passport) Gender: ❒ male ❒ female Date of Birth: _____/_____/________ Country of Birth: _______________________ month / day / year City of Birth: _____________________ Country of Citizenship: _______________________ E-mail address: _____________________________________________________________ Permanent Mailing Address (your country): Current Mailing Address (Immigration documents will be sent here): _________________________________________________ ____________________________________________________ Number and Street Apt. # Number and Street Apt. # _________________________________________________ ____________________________________________________ City State City State _________________________________________________ ____________________________________________________ Country Postal Code Country Postal Code _________________________________________________ ____________________________________________________ Telephone Number Telephone Number Please note that all course times are dependent on room availability and are subject to change. 7) US VISA INFORMATION: A. If you are in the US now, what kind of visa do you have? ❒ F-1 ❒ J-1 ❒ Other (please specify): ________ B. Do you have a SEVIS ID number? ❒ Yes ❒ No If yes, please write your SEVIS ID here: _____________________________ C. If you are transferring from another school in the US, please provide the school name and contact information: School name:______________________________ Telephone: _______________________ Fax: ____________________________ If you have dependents who need immigration documents, please add their information below (attach additional pages if needed): Name Date of Birth (month/day/year) Country of birth Country of citizenship Relationship to student _____________________________________ ______________ ____________ ____________ _______________ 2) PROGRAM 3) SESSION (Dates on p. 1) Weeks ❒ AEP (Intensive Only) ❒ Spring 2016 15 ❒ ELP intensive ❒ Summer 2016 10 ❒ ELP part time ❒ Summer 2016 – AEP ONLY 4.5 ❒ Summer 2016 – ELP ONLY 5 ❒ Fall 2016 15 4) ELECTIVE COURSES (OPTIONAL): 6-week courses / TTH mornings. Students can take a maximum of 2 during Fall or Spring and one during the 10-week Summer program. 5) ELP part-time applicants only: You may take a maximum of three core courses, or two core courses and two elective courses. Part-time students are not eligible for student visas. 6) I-20: Do you need a Form I- 20? ❒ Yes ❒ No Must show enough financial support for requested duration. See p. 1 Estimated Expenses. Course Minimum Proficiency Course Days Times If yes, choose one. ❒ TOEFL Preparation Intermediate ❒ Writing MWF 9-10:30 ❒ 1 session ❒ IELTS Preparation Intermediate ❒ Grammar MWF 11-12:30 ❒ 2 sessions ❒ Pronunciation High Beginner ❒ Listening/Speaking MWF 2-3:30 ❒ 1 year ❒ GRE Preparation High intermediate ❒ Reading and Discussion TTH 1-3:15 Application for ESL Programs: Academic English Program (AEP) and English Language Program (ELP) awer Intensive Study: You will have 4 core courses: Writing, Grammar and Idioms, Listening/Speaking, Reading and Discussion. Part-Time Study: Maximum of 3 core courses, or 2 core and 2 elective courses. Proficiency Requirement: ELP offers instruction to adults at all levels. AEP requires at least low-intermediate proficiency based on our placement test or TOEFL PBT of 425+ (113+ CBT/38+ iBT) AND a Bachelor’s (4-year) degree. Students applying to AEP will be placed in ELP if they do not meet these minimum qualifications.
  • 3. 3 8) EDUCATION INFORMATION: What is your highest education degree? ❒ High School ❒ Bachelor’s/Undergraduate (4-year) ❒ Master’s ❒ Ph.D. Graduation year: ________ Institution: _____________________________________ Field of study: __________________________ Do you already have a UT EID? If yes, write it here: _______________________ If you have taken the TOEFL or IELTS exam, write your score here: _________ Date of test: __________ 9) FINANCIAL GUARANTEE STATEMENT: (F-1 or J-1 Students Only) Person who is financially responsible: ❒ Applicant ❒ Parents/Family ❒ Sponsor If you will be funded by family or a sponsor, please write that information below. __________________________________________________________ Name of financially-responsible party __________________________________________________________ Address __________________________________________________________ __________________________ _____________________________ Telephone Fax By signing below, I certify that funds are available for the total expenses, and will be provided as specified. Parent or Sponsor Signature: ____________________________________________ Date __________________ 10) CERTIFICATION: All applicants complete: ❒ I have read and completed this form, and I certify that the information provided is accurate and complete. ❒ I understand that I am responsible for arranging my own housing and transportation from the airport. ❒ I understand that admission to ESL Services is not a guarantee of admission to any other program at The University of Texas at Austin. AEP applicants complete: ❒ I am enclosing a copy of a diploma/transcript which shows I have completed at least a Bachelor’s/Undergraduate (4-year) degree. ❒ I understand that if I do not meet minimum qualifications for AEP admission, I will be placed in ELP. _____________________________________________________________ ___________________ Applicant’s signature Date 11) PAYMENT INFORMATION: Payment in full is due at registration. Tuition and other fees may be paid with MasterCard, Visa, US currency, a bank draft, or money order in US dollars, traveler’s checks, or a personal check from a US bank. New students who will apply for an F-1 or J-1 visa must pay $350 USD (non-refundable). This payment covers your $200 SEVIS fee, express mail & document processing fee of $50, and a $100 tuition deposit. The SEVIS fee is mandatory for all new students applying for an initial F-1 or J-1 visa. It is used by the Department of Homeland Security to maintain the SEVIS (Student & Exchange Visitor Information System) database. All other applicants must pay a non-refundable tuition deposit of $100 USD, which will be applied to the cost of the program upon admission. ❒ I am enclosing or authorizing charges of $350 for SEVIS fee payment, express mail & document processing, and tuition deposit. (I do need an F-1 or J-1 visa). ❒ I am enclosing or authorizing charges of $100 for my tuition deposit. (I do not need an F-1 or J-1 visa, or I am transferring from another school in the US). Payment type: ❒ Bank draft/money order ❒ Traveler’s check/personal check (payable to “The University of Texas at Austin”) ❒ MasterCard ❒ Visa If paying by credit card, please complete: Card Number Expiration (month/year) CVV (security) code Printed name of cardholder: ____________________________________ Authorized signature: _________________________________________ After receiving ALL required information listed above, your application will be processed and applicable immigration documents will be sent to you. Last revised 10/29/2015 United States Customs and Immigration Services requires that students give evidence that they are able to pay all tuition, fees, and living expenses while studying in the US before a school issues a Form I-20. Attach a letter of financial guarantee from the bank of the responsible party showing sufficient funds are available for the total expenses (See Estimated Expenses on p. 1). Additional funding is required when dependents accompany the student.