STATE UNIVERSITY OF NEW YORK AT NEW PALTZ 
APPLICATION FOR EXCHANGE PROGRAM 
 
1. Name:   
 
 
 
 
Last (Family) Name 
First Name 
Middle Name 
 
2. Current Address 
Permanent Foreign Address 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Email:  
 
Email:  
 
 
 
Telephone #:  
 
Telephone #:  
 
 
 
Fax #:  
 
Fax #:  
 
 
We will send all documents to your current address unless you request otherwise. 
 
3. Country of Birth 
 
Country of Citizenship  
 
 
 
Country of Legal Permanent Residence  
 
 
 
 
 
 
4. City of Birth:  
 
 
 
5. Gender:  
 
Date of Birth:  
 
 
 
 
 
 
 
Month 
Day 
Year 
 
6. Duration of Program: Fall Semester 
Spring Semester 
Full year 
 
 
7. Status at home Institution:  
 Undergraduate   
Graduate 
  
 Other  
 
8. Name of home university:   
 
 
 
 
 
 
 
 
 
Academic Department or Division:   
 
 
 
 
 
 
 
 
 
 
Academic Discipline or Major:   
 
 
 
 
 
 
 
 
 
 
Please provide your most recent course transcript. 
 
9. Source of Financial Sponsorship:  Family/Self   
Your university   
 
 
 
 
US Government   
Your government  
International Agency    
 
 
 
Other:   
 
 
10. Financial Certification:  Please provide financial documentation verifying your ability to cover 
your living expenses for the full period of time that you will study at SUNY New Paltz.   
Full year: $11,660 
 
Semester:  $5,910 
 
11. Your Signature:   
 
 
 
 
 
 
 
 
* Please include a copy of your passport page with this application