International Exchange Application

Complete the following application to initiate the student exchange process.

If you have any questions please contact the International Programs office at international@roosevelt.edu.

Biographical Information

First Name (Given)

Middle Name

Last Name (Family)

Birthdate

Sex

Are you a U.S. permanent resident?

Yes

No

Country of Citizenship

Country of Birth

Country of Legal Permanent Residence

Contact Information

Email Address

Phone Number

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Country

Street

City

Region

Postal Code

Academic Information

Home Institution

For Performing Arts degree students only

Institutional Level of Study

Current Field of Study

Home Institution Contact Name

Home Institution Contact Title

Home Institution Contact Email

Exchange Program Plans

Intended start of exchange program

Intended length of exchange program

Level of study

Are you pursuing the 1+1 MBA Program through Roosevelt University and Gems B School?

Which content area are you interested in taking courses?*

English Proficiency Documentation

English Proficiency Documentation is required for admission. Please upload a copy of your a recent TOEFL, IELTS, Pearson Test of English, Michigan English Test, or West African Senior School Certificate Exam:

TOEFL:

IELTS:

PTE (Pearson Test of English):

Michigan English Test:

West African Senior School Certificate Exam:

Please upload a copy of your transcript

Transcript

International Exchange Interest Information

Please briefly explain why you are interested in studying abroad at Roosevelt University?

Do you plan to live in one of our residence halls on Roosevelt University’s Chicago campus?
We strongly recommend undergraduate exchange students to live in one of our residency halls.

Emergency Contact

First Name (Given)

Last Name (Family)

Relationship Type

Email Address