ALL applications and materials must be recieved by: Fall Term Applications Due By: Spring Term Applications Due By: December 1

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Special Student Admissions

MIT Office of the Dean for Graduate Education Building 35-332

77 Massachusetts Avenue Cambridge, MA 02139-4307 Phone (617) 253-2917 Email: mitspecial@mit.edu

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

Fall Term Applications Due By:

ALL applications and materials must be recieved by: May 1 Spring Term Applications Due By: December 1

UNDERGRADUATE SPECIAL STUDENT STATUS

A person seeking admission as a non-degree undergraduate Special Student must apply through Special Student Admissions. Complete applications for a given term must be filed before the deadlines given above, including a $75 application fee. All materials must be mailed to the provided address. 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 Special Studnet 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 Student Admissions notifies all applicants of admissions decisions. If the applicant is admitted, further information about registration and tuoin payment options will be provided.

Current course offerings are viewable online at http://web.mit.edu/catalog/. APPLICATION PROCEDURE

A person who does not possess an undergraduate degree will be considered an Undergraduate Special Student. 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.

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 Special Student 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

If you are enrolled at another university and wish to study subjects not offered at your home university, you may apply to MIT as a non-degree undergraduate Special Student. Special Student status is available to individuals who have successfully completed at least one year of full-time study, or the equivelent, at the university level. Secondary school students are not eligible.

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 candidate at a later time.

Although applicants are considered undergaduate special students, the adminstration and application process is held within the Office of the Dean for Graduate Education.

If you hold a bachelor’s degree or higher, and are interested in taking classes as a non-degree student at MIT, you must apply through MIT’s Advanced Study Program. Please visit their website at http://advancedstudy.mit.edu or contact them at advancedstudy@mit.edu for more information.

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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. All transcripts must be certified and officially translated into English.

After admission to MIT, 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 will cover 36 units or more.

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 are not permitted to cross-register at Harvard University.

INTERNATIONAL STUDENTS

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. For information about tuition and fees please visit the Office of the Registrar at:

http://web.mit.edu/registrar/reg/costs/special/specialtuition.html

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 is required of all Special Students who are not MIT employees, employee dependents, 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).

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 requirement.

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 http://medweb.mit.edu/healthplans/student/index.html, or contact the Student Health Plan office at 617-253-4371 or stuplan@med.mit.edu.

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@med.mit.edu.

MEDICAL CARE 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 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 successfully 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 http://hrweb.mit.edu/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 approval by signing in Section 9 of the application form. Signature approval must be obtained prior to submitting the application.

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4 _{Biographical information}

Applicant’s legal name __________________________________________________________________________________________________________

Last/Family/Surname First/Given name Middle Suffix (Jr., III, etc.)

Applicant’s preferred first name___________________________________

oFemale oMale Date of birth __________________________ Place of birth_________________________________________________

Month/Day/Year City/State or province/Country

A P P L I C A T I O N F O R S P E C I A L S T U D E N T A D M I S S I O N

This is the application to study at MIT as a non-matriculating, non-degree student. This form must be submitted each semester. This application plus supporting documents must be submitted by:

ALL applications due by:

Fall Term May 1

Spring Term December 1

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2_{I am applying for:} oFall Term 20____ oSpring Term 20____

3 Have you ever applied to MIT before? oYes oNo If yes, select appropriate boxes and indicate term and year:

oUndergraduate _________________

oGraduate ______________________ oSpecial ________________________ oTransfer _______________________ Did you enroll? oYes oNo

If you enrolled, have you ever withdrawn from MIT? oYes oNo Last/Family/Surname First/Given name Middle initial Date of birth (Month/Day/Year)

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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 application may be cause for refusal or cancellation of admission as a Special Student.

Signature Date

Addresses

• Please notify us if your address changes. Home (permanent) address

Street address

City State or province ZIP or postal code

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Country Area or country code Telephone

Mailing address (if different from your home address) Street address

City State or province ZIP or postal code

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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

oFull-Time Status oLess than Full-Time Status (e.g. Part-Time, Half-Time, etc.) 2_{I am applying for:}

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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 Yes, my registration number is__________________________ 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

__________________________ 7 Optional (U.S. citizens and permanent residents only)

• Choose one option below. U.S. Citizen

U.S. Permanent Resident (Green Card holder)

Country of citizenship _______________________________ Attach a photocopy of your Green Card.

Non-U.S. Citizen/Non-U.S. Permanent Resident

Country of citizenship _______________________________ Visa Type (if applicable) _____________________________

(F-1, J-1, etc.) 6 _{Citizenship information}

Company Supervisor

City State

Country

If you are employed by MIT, please specify:

oStaff oNon-Staff oLincoln oOther

Department

Supervisor name, title, and MIT extension (please print)

Supervisor signature of approval Date 8 _{Educational History}

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(e.g.BA,BS,etc.)

Name Date entered

City State Date departed

ZIP/Postcode Country Degree(e.g.BA,BS,etc.)

9 _{Employer Information}

Please give the name of your employer, if other than MIT.

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A P P L I C A T I O N F O R S P E C I A L S T U D E N T A D M I S S I O N

Last/Family/Surname First/Given name Middle initial Date of birth ( Month / Day / Year )

12 _Courses

Please list the courses you would like to enroll in. MIT employees are eligible to receive Tuition Assistance for one course per term. 11 _Statement

What is your objective in applying for admission as a Special Student? Please be specific. Please attach a separate sheet of paper.

Course number Course title

Number of units (e.g., 6, 9, 12, 15)

Department signature Date

Approved Not Approved Undergraduate Graduate

Special Student Admissions signature Date

Approved Not Approved Undergraduate Graduate For department use only.

10 _{Non-native English speakers}

Please indicate your TOEFL or IELTS score and date of test.

Test score Date of test

Class listings may be found online at: http://student.mit.edu/catalog/index.cgi

***IMPORTANT*** Please make sure to read the symbols help page at: http://student.mit.edu/catalog/symbols.html.

Classes with the leaf symbol are availible in the Fall term. Classes with the flower symbol are availible in the Spring term. Classes with the slash symnol are not availible. If you choose classes that are not availible for the term you apply for your application will not be approved.

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CHECKLIST

oCompleted Application Form oOfficial Transcript(s) in English oEvaluation Form

o$75 non-refundable application fee (U.S. dollars)

Use a check or money order payable to MIT Special Student Admissions International Students

oPhotocopy of Permanent Resident or Green Card (if applicable) oTOEFL or IELTS score (photocopy of the official score report)

Mail application packet to:

MIT Office of the Dean for Graduate Education

Building 35-332

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 http://mitpress.mit.edu/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: http://web.mit.edu/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.

* The 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 MIT Annual Security and Fire Safety Report for 2012, prepared by the MIT Police Department, is a comprehensive publication required by the Department of Education, also known as the Jeanne Clery Act. This publication provides an overview of the MIT Police Department, it services, cam-pus security policies, and crime and fire statistics, is available upon request from MIT Police Headquarters, at W89, 77 Massachusetts Ave., Cambridge, MA 02139-4307 or online at http://web.mit.edu/cp/www/_docs/MIT-Police-security-report-2012.pdf This handbook is also available at HR and from the Admissions Office.

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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 35-332, MIT