Thank you for your interest in USC-SJTU Global EMBA Program.
We aim to make your application process easy and convenient.
1. Please complete this form and send it back to us ().
2. We will then create a USC application account for you, andyou will receive aPIN and password.
3. You will logon to the system to complete some final itemsandpay your application fee online(by card only: Visa, MasterCard, or Discover).
If you have questions about the application process, please contact us:
USC GEMBA Shanghai Office:
Tel:+86 -21-6293-2707
Add: Room 102, South Bldg, Shanghai Jiaotong University, 535 Fahuazhen Rd, Shanghai
We look forward to reviewing your application!
►Personal Information:
1. LegalName :*( Please type your name exactly as it appears on your passport.)
Salutation / Last Name (Legal, Family)* / Middle Name
/ First Name*
2.Gender:*MaleFemale
3.Your Native or First Language*
4.Marital Status:
5.Primary Telephone #*:(Please include country code. )
Alternate Telephone #:(Please include country code. )
6.E-mail Address*:
Alternate Email Address #:(Please include country code. )
►Birth Information:*
1.City of Birth
2.U.S. State/ Territory*
3.Country of birth*
If your birth country was not in the list, please type it in the space provided.
4.Date of Birth:*
Month Day Year (YYYY)
►Ethnicity and Race*:
1.What is your ethnicity?
2.Please select your race from the options below:
(You may select more than one option by holding down the CTRL button on your keyboard.)
►USC Relationship:
1. Are you a USC alumnus/alumna?*YesNo
2.If your answer to Q1 is YES, then your USC ID:(Format: ####-####-##)
3. Did your parents or siblings attend USC?*Yes No
4. Are your parents or your spouse employed by USC?*Yes No
►Financial Aid*:
1. Will your tuition be sponsored by your company?Yes No
If yes, please indicate the dollar amount or percentage of tuition that will be covered
2.(To US Citizens ONLY)Please indicate if you will apply for, or are interested in financial assistance including federal loans, work-study and private financing programs.*YesNo
►Demographic Information
At USC, an international student is an individual of foreign nationality who will be entering or has already entered the United States with a student visa. However, students already residing in the U.S. and holding other non-immigrant status visas (such as B1, B2, H4, or L2, for example) are also international students.
All international students must complete the "International Applicants" section before submitting the application.
1. Residency:*
(Please indicate your residency status*)
2. Alien Registration #:
U.S. Permanent Residents: Your Alien Registration Number may be found on your permanent resident card or other documents provided to you as proof of legal permanent residence.
3. Country of Citizenship*
Others:*
4. Social Security #
Please provide your SSN (###-##-####) if you intend to apply for federal Financial Aid. This information will speed the processing of your Financial Aid file.
►Current Address
Please note that questions followed by an asterisk * are required in order to submit an application.
(For addresses OUTSIDE of the United States, please include the province, territory and postal code after the city name.)
Street Address 1* City*
Zip/Postal Code(For addresses outside of the United States, please include the province, territory and postal code after the city name)
U.S. State/ Territory*
Country*
Country - Other:(If your country is not in the list, please type it in the space provided.)
►High School / Secondary School Information
Please indicate the high school / secondary school from which you received your diploma.
Name of school at which you have earned or will earn your diploma*
City* U.S. State/ Territory, Province or Region*
Country*
Dates
of Attendance: / From: / To:
Month /
Year (YYYY) /
Month /
Year (YYYY)
Graduation Date:* / Month / Year (YYYY)
►Colleges and Universities Attended
Name of College / University City Country
U.S. State / Territory, Province or Region
Dates
of Attendance* / From: / To:
Month /
Year (YYYY) /
Month /
Year (YYYY)
Degree Received:* / (If your degree type was not in the list, please type it in the space provided. Provide the name of the degree as it is called in that country.)
Major:* /
Graduation Date: /
Month /
Year (YYYY)
►Employed Information
1. How many total months of full-time work experience will you have by the time you begin the program? Numbers only, please
2. Current/Last employer:
Company/ OrganizationPosition Nature of Position
Employment Began (Date):DD/MM/YY
Employment Ended (Date):DD/MM/YY
Job Function:
Industry:
Salary Information:$( Round to the nearest 1000)
►International Applicant's Confirmation
I confirm that the information in the Biographical Section of this application - Legal first and last name, and middle name (if applicable), date of birth, county of birth and county of citizenship - matchesexactlymy information as it is listed on my passport. I understand that this information will be used to issue my I-20 or DS-2019 form, and that failure to provide complete and accurate information mayseverely delaythe processing of my application.
Do you confirm this statement?*
Yes No
Your Signature: ______
Date: ______