<p> Summer SALISBURY UNIVERSITY Salisbury University 2016 ISAP APPLICATION Center for International Education 1101 Camden Avenue Salisbury, MD 21801-6860 Salisbury University Phone: 410-677-5495 B1/B2 Visa Program Fax : 410-677-6563 Intensive Study Abroad Program (ISAP) www.salisbury.edu/intled/ th Dates: July 18 , 2016 – August 12, 2016 email: [email protected]</p><p>I. PERSONAL INFORMATION</p><p>Name: ______(First/Family Name) (Last/Given Name) </p><p>Date of Birth: ______Gender: □ Female □ Male</p><p>Mother/Father/Sponsor Name: ______</p><p>Are you in the U.S? □ Yes □ No If yes, what is your current immigration status? ______</p><p>Please include a copy of the identification page of your passport, and of your I-94 (if in the United States).</p><p>Country of Birth: ______Country of Citizenship: ______</p><p>Country of Permanent Residence: ______</p><p>Address Abroad: ______</p><p>______</p><p>Telephone Number: ______E-mail Address: ______</p><p>II. DEPENDENT INFORMATION If you plan on bringing dependents (spouse, children), please provide the following information for each one of them: name, date of birth, place of birth and country of permanent residence/citizenship. There is additional cost for dependents. Please contact SUCIE for information.</p><p>III. FINANCIAL INFORMATION</p><p>Tuition cost of $2200.00 due upon arrival to Salisbury University Cashier’s Office. Summer program tuition must be paid by July 18th, 2016. </p><p>IV. TO BE COMPLETED BY SALISBURY UNIVERSITY</p><p>I certify that I have reviewed the information and all attached documents and approve issuance of admission to the Salisbury University Intensive Study Abroad Program (ISAP- B1/2)</p><p>Jessica Emhoff, SU ELI Program Coordinator Date</p>