TUP Initial Application

The David T. Kearns Center for Leadership and Diversity in Arts, Sciences and Engineering
TUP @Rochester

PLEASE NOTE: The classes and fees associated with the Top Universities Preparatory (TUP) Program are intended for high school students completing the 11th or 12th grade, who are traveling to the US without dependent family members (i.e. spouse and/or children). Please submit application with all required documents no later than May 28, 2021 to begin the program in the Fall of 2021.
Biographical Information

(Please write your biographical information exactly as it appears in your passport.)
Legal Name:*

First (Given) NameMiddle NameLast (Family) Name
English Name*
With which gender do you identify?*

MaleFemaleNon-binaryChoose not to discloseOtro
Date of Birth:*

MonthDayYear
(Please use the following format: Month - Day - Year)
Country of Birth:*
In which country were you born?
Country of Citizenship:*
If you have multiple citizenships, please separate each country of citizenship with a comma
Country with legal permanent residence status (if other than country of citizenship):*
Please list any country in which you have legal permanent resident status, but are not a citizen
If you are now in the U.S., what is your current visa/immigration status?*

U.S. CitizenU.S. NationalCompacts of Free AssociationVisa Waiver ProgramNonimmigrantAlien
Please upload a copy of the biographical page of your passport here:*

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This is the page of your passport that lists your full name, photo, passport number and issue/expiration dates Cancelof
Program Information
High School Name:*
High School Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School Counselors Name:*

First NameLast Name
Have you received your high school (secondary school) diploma or equivalent?*
Are you currently enrolled at another high school or university?*
If yes, please supply the name of the institution:*
Please provide the full name as listed on the institution's documentation
In what country is this institution located?*
Current SAT Score (if known):
Current TOEFL Score (if known):
Program Eligibility

A minimum GPA of 3.0 on a 4-point scale is required for admission to the TUP Program. Candidates must provide their secondary school transcripts translated in English to gain admission to the TUP program.
Please upload a copy of you secondary school transcript here:*

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Proof of Funding

The TUP Program includes the following fees:
- Application fee
- Non-refundable deposit
- Summer, Fall and Spring tuition, fees and health insurance
- Housing, meals and ground transportation between the TUP Academy and the University of Rochester
Proof of funding for this program must be documented. Acceptable documentation includes a personal bank statement or certificate of deposit verifying $USD in the amount of $55,200. If bank records are in a name other than your own, the bank account owner must attach a letter verifying that the funds are available to support your expenses during the period of the program.
What is your source of funding?*
Please upload a copy of your proof of funding here:*

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Please click here to download and complete the Certification of Funds. This form is required in order to process your Form I-20.
Please upload a completed Certification of Funds form here:*

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Health Insurance

All F-1 visitors are required to have medical insurance. The cost of insurance has been included in the overall price of your program.

Immunization and Health Testing information is required by New York State laws. Please click here to download and fill out the form.
Please upload a completed Immunization and Health Testing form here:*

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Accepted Students

Once you have arrived in the U.S., you must upload the following documents:
Signed I-20 (Page 1):*

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Please upload the first page of your I-20 once it is signed and completed Cancelof
F-1 visa page in passport:*

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Please upload the page of your passport containing your F-1 visa Cancelof
F-1 D/S Entry stamp in passport:*

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This may be located on the page opposite your visa Cancelof
Contact Information
What is your primary email address?*
example@example.com
What is your permanent address in your home country?*

Street Address

Street Address Line 2

CityProvince

Country
What is your primary phone number in your home country?*

Area CodePhone Number
What is your permanent address in the United States?*

Street Address

Street Address Line 2

CityState

Zip code
What is your primary phone number in the United States?*

Area CodePhone Number
Standards of Student Conduct

All TUP Program participants must read and agree to abide by the University of Rochester Standards of Student Conduct. Please click here for the a copy of the Standards of Student Conduct.
Please ensure both student and parent/guardian have reviewed and signed the Standards of Student Conduct and upload a copy of the final signed page here:*

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By submitting this form, I certify that I have reviewed and will follow University of Rochester and TUP Academy policies and procedures, and am aware of the tuition and fees, class meeting schedules and deadlines. Furthermore, I certify that the information I have entered on this form is true and correct to the best of my knowledge. I have read and agree to abide by the University Standards of Student Conduct and understand that infractions will lead to the imposition of sanctions. I also understand that I am fully liable for all university tuition and/or fees association with my registration and will make payment or arrangement for payment suitable to University of Rochester and TUP Academy prior to attendance. I understand that transferability of credits is solely determined by the institution(s) to which I apply or in which I am matriculated. In addition I recognize that registering for the TUP program does not guarantee acceptance into any academic degree program offered at University of Rochester.*

I have read and agree to the terms listed above
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The David T. Kearns Center for Leadership and Diversity in Arts, Sciences and Engineering

TUP @Rochester