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S T U D E N T
I N F O R M A T I O N
Office of Admissions
Massachusetts Institute of Technology
Room 3-103 (S)
77 Massachusetts Avenue
Cambridge, MA 02139-4307
Phone (617) 253-2917
mitspecial@mit.edu
S H E E T
S P E C IA L S TU D E N T D E A D LIN E S
International
Students
Fall Term
August 1
June 1
Spring Term
January 1
November 1
Summer Term
May 1
March 1
QUAL I F I CAT I O NS
A person who does not possess an undergraduate degree will be considered an Undergraduate Special Student. A former MIT student who has withdrawn
for any reason and wishes to be readmitted should apply to Counseling and Support Services (after a first required withdrawal) or the Committee on Academic
Performance (after a second required withdrawal). 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.
A candidate for admission as a Special Student who holds an undergraduate degree and is currently enrolled in a degree program will be considered a
Graduate Special Student. Graduate Special Students are limited to three terms. An applicant who was formerly enrolled at MIT as a degree-oriented graduate student and who has not subsequently obtained a degree must have the approval of the Office of the Dean of the Graduate School to be considered for
admission as a Special Student. Similar approval is required if the applicant has received a formal warning or disqualification for poor academic performance
in an MIT department other than the one to which the applicant seeks admission. NOTE: The Department of Mechanical Engineering will not accept a Special
Student application from anyone who has been denied admission to their graduate degree program.
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 applicants 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 the Office of 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.
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
MIT E M P L O Y E E S
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 by the Office of Admissions 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 to the Office of Admissions.
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. The tuition fee for Special Students in the 2013-2014 Fall and Spring terms is $670 per unit, with a minimum charge of $6,030 and a
maximum charge of $21,605. For Special Students who are employees of MIT and dependents of MIT employees, regular (undergraduate or graduate) MIT
students and dependents of regular students, the minimum tuition is $4,020. The fee for Special Students in the Sloan School of Management is $1,171 per
unit with a minimum charge of $10,539 and a maximum charge of $38,225.
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 of $140 is required of all Special Students who are not MIT employees, employee dependents, MIT students 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).
MEDICAL CARE
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.
A P P L I C A T I O N
F O R
S P E C I A L
Office of Admissions
Massachusetts Institute of Technology
Room 3-103 (S)
77 Massachusetts Avenue
Cambridge, MA 02139-4307
S T U D E N T
A D M I S S I O N
1
Last/Family/Surname
First/Given name
Middle initial
This is the application to study at MIT as a non-matriculating, non-degree oriented student. This form must be submitted each semester. This application plus
supporting documents should be submitted by:
International
Students
Fall Term
August 1
June 1
Spring Term
January 1
November 1
Summer Term
May 1
March 1
o Yes o No
o Undergraduate _________________
o Graduate ______________________
o Special ________________________
o Transfer _______________________
o Yes
o No
o Yes
o No
4 Bi ogr a p h i c a l i n f o r m a t io n
Last/Family/Surname
First/Given name
Middle
o Male
5 Addr es s e s
Street address
Street address
State or province
Country
City/State or province/Country
If your mailing address differs from your home address, mailing address
City
Place of birth_________________________________________________
City
Telephone
Country
State or province
(
Area or country code
)
Telephone
Email address
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 a
pplication
may be cause for refusal or cancellation of admission as a Special Student.
Signature Date
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
6 Ci ti z en s h i p i n f o r m a t i o n
Country of citizenship________________________________
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)
Which best describes your background?
Central America
Cuba
Mexico
Puerto Rico
South America
Spain
Other__________________________
No
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___________________________
8 E duca t i o n a l H i s t o r y
List any technical institutes, junior colleges, four-year colleges or universities you have attended, or are currently attending (including MIT).
Name
Date entered
Name
Date entered
City
Date departed
City
Date departed
Degree
ZIP/Postcode Country
State
ZIP/Postcode Country
State
Degree
9 E m pl o y e r I n f o r m a t i o n
Company
Supervisor
Department
City State
Supervisor name, title, and MIT extension (please print)
Country
Supervisor signature of approval
Date
A P P L I C A T I O N
F O R
10 Non-n a t i v e E n g l i s h s pe a k e rs
S T U D E N T
A D M I S S I O N
Last/Family/Surname
S P E C I A L
First/Given name
Middle initial
Date of test
11 S tatem e n t
What is your objective in applying for admission as a Special Student? Please be specific. (Please attach a separate sheet of paper if necessary.)
12 Cour s e s
Please list the courses you would like to enroll in. MIT employees are eligible to receive Tuition Assistance for one course per term.
For department use only.
Course number
Course title
Department signature
Date
Approved
Graduate
Course number
Department signature
Date
Approved
Graduate
Course number
Department signature
Date
Approved
Graduate
Course number
Department signature
Date
Approved
Graduate
Course number
Department signature
Date
Approved
Graduate
Course title
Course title
Course title
Course title
Not Approved
Not Approved
Not Approved
Not Approved
Not Approved
Undergraduate
Undergraduate
Undergraduate
Undergraduate
Undergraduate
Date
Approved
Undergraduate
Not Approved
Graduate
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
CHE CKLIS T
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
Office of Admissions
Massachusetts Institute of Technology
Room 3-103 (S)
77 Massachusetts Avenue
Cambridge, MA 02139-4307
Phone (617) 253-2917
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.
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