Application for Siena International Exchange

Student Information

First Name (Given Name)*

Last Name (Family Name)*

Middle Initial

Birthdate*

Gender*

Home Phone

Cell Phone

Email Address*

Birth Country*

Country of Citizenship*

Mailing Information

Permanent Address*

Country

Street

City

Region

Postal Code

Current Address (If different from Permanent Address)

Country

Street

City

Region

Postal Code

Passport Information

Passport Number*

Issuing Country*

Expiration Date*

Are you a United States Citizen?*

US Citizenship - Hidden

Do you currently hold a Visa to study in the US?*

Yes

No

What is your Visa status?

Academic

What is your major/field of study at your home institution?*

What do you intend on studying at Siena?

School Information

Delete School # _ID_
List all the colleges/universities you have attended, with current or most recent first. Type your school name in the text box and once it appears click the school to populate. If your school is not listed select Unknown College/ Unknown High School.
School Name School Level of Study * School Start Date School End Date School Graduation Date School Ceeb Code

Add Another School

List all courses in which you are currently enrolled

Course 1 Name

Course 2 Name

Course 3 Name

Course 4 Name

Course 5 Name

Course 6 Name

Course 7 Name

Course 8 Name

Course 9 Name

Course 10 Name

Application

Term you wish to enter:

Is English the primary language spoken at home?*

Yes

No

Select primary language spoken at home*

Have you taken the English Proficiency exam? (ie. TOEFL, IELTS or Duolingo)*

Yes

No

Upload your English Proficiency exam score

Please indicate briefly why you are interested in Siena University*

Parent/Guardian

Relation 1 Type

Relation 1 First Name

Relation 1 Last Name

Relation 1 Email

Relation 1 Employer

Relation 1 Occupation

Relation 1 Address (If different from student)

Country

Street

City

Region

Postal Code

Relation 2 Type

Relation 2 First Name

Relation 2 Last Name

Relation 2 Email

Relation 2 Employer

Relation 2 Occupation

Relation 2 Address (If different from student)

Country

Street

City

Region

Postal Code

Is there any other information that you want us to consider in interpreting your academic record? If so, please explain here:

Upload Your Transcript

I confirm that I am in good standing at my current school and all previous secondary or higher education institutions.*

I certify that the information I have submitted in this application is complete and true to the best of my knowledge. I agree that if I am accepted for admission, I will comply with all the rules and regulations of the College that may be in effect or that will be put into effect while I am a student.*

Signature