Student Application

Back

Tuition Exchange Program—Student Application
For enrollment during the 2024–2025 academic year

To apply for CIC-TEP, please complete the following application. Only submit this application if the student will be using CIC–TEP for the first time during the 2024–2025 academic year (even if s/he isn't new to the institution).

Basic Information
- For new enrollment during this academic year:
- Exporting (Home) Institution *
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##

Student Information

First Name *
Last Name *
SSN (Last 4 Digits) *

Date of Birth *

Open the calendar popup.

Student Address: Street *
Student Address: Street 2 (Apartment #, etc.)
Student Address: City, ST ZIP *
Student Email *

Employee Information
- Employee First Name *
- Employee Last Name *
Select up to eight importing institutions.
If the student is applying to more than eight institutions, please submit another new application form.
- Importing Institution *
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 2
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 3
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 4
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 5
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 6
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 7
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
- Importing Institution 8
  
  {1}
  
  ##LOC[OK]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
  
  {1}
  
  ##LOC[OK]## ##LOC[Cancel]##
Consent
- I confirm that I am at least 16 years old and agree to have CIC store and process the data in this form and share it with select institutions. I also understand that the exporting liaison can make changes to this application before sending it. *
  
  Yes No