Application for Admission
For the MIT Advanced Study Program

(*) indicates required information.

ALL REQUIRED INFORMATION must be completed. If you get an error message, use the 'back' button on your browser, complete the missing information, then submit again.

Application Reference Information
*Full Name:
*Preferred Email Address:
 (required)

Term(s)

    Please check year for each semester you expect to attend:

    Fall 2013 Spring 2014

    Please check how many classes you plan on taking per semester, this will determine your invoice: (International Students must have 36 credits minimum)

    Three to four classes (36 to 48 units/credits) $24,120 (full time)

    Two classes (up to 24 units/credits) $16,080 (half time)

    One class (up to 12 units/credits) $8,040 (quarter time    )

Personal Information
Prefix:
 Dr.Mr.Ms.Mrs.
*Family Name (only):
*First Name (only):
Middle Initial:
*Date of Birth:
 MonthDayYear
*Birthplace:
 City
State
Country
*Country of Citizenship:
*Country of Permanent Residence:
*Address to Reply:
 BusinessHome (Please Check One)
Family Information
(REQUIRED for non U.S. citizens whose spouse & children will also come to the U.S.)
Married?
 YesNo
Will your spouse be with you?
 YesNo
 If yes, please fill out this information:
Spouse's full name:
Will your children be with you?
 YesNo
 If yes, please fill out this information:
Names and ages:

Business Address
*Business Name:
*Business Address:
*City, State, Country, Zip Code:
*Your Position:
*Telephone (voice):
*Telephone (fax):
*Email address:

Home Address
*Home Address:
*City, State, Country, Zip Code:
*Telephone (voice):
Telephone (fax):
Email address:

Have you ever applied to MIT Before?
YESNO
If Yes, please indicate the year and the program you applied for:

Education
University Study 1
*University 1:
*Dates attended:
*Major Field:
*Degree Obtained:
University Study 2
University 2:
Dates attended:
Major Field:
Degree Obtained:
Describe or list other education programs and courses in which you have participated:

Support Material

See Support materials needed for regular applicants

See Support materials needed fo MIT Staff applicants

Please send all support materials by email to advancedstudy@mit.edu or by mail to:
MIT Professional Education
Attn: Advanced Study Program
77 Massachusetts Avenue, Building 35-433
Cambridge, MA 02139-4307
USA

How did you hear about the Advanced Study Program?

Thank you for applying to the MIT Advanced Study Program. By submitting this application you are confirming that all the information is complete, factually correct, and honestly prepared.



Please submit this application electronically by pressing the "submit" button above.

Please be patient. Processing may take up to one minute.

If you prefer, you may print and mail or fax the completed application to the following address below. In either case, you must send all supporting materials to the address below.


    MIT Professional Education
    Attn: Advanced Study Program
    77 Massachusetts Avenue, Building 35-433
    Cambridge, MA 02139-4307
    U.S.A.

    If you have any questions, please call 617-253-6128; fax: 617-258-8831, or e-mail: (advancedstudy@mit.edu).