ADMIT INTL MATRICULATION

I have read and understand the above. (PLEASE PRINT ALL INFORMATION)

ENROLLING STUDENT’S PRINTED NAME

ENROLLING STUDENT’S SIGNATURE DATE

STUDENT IDENTIFICATION NUMBER (SEE LETTER OF ADMISSION)DATE OF BIRTH (mm/dd/year)

PARENT OR GUARDIAN SIGNATURE [in the case of students who are legally minors (under age 18)]

TELEPHONE (INCLUDING COUNTRY CODE) E-MAIL

Please complete other side

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REV 2.18

Admitted International Student

Matriculation Form

To verify important information and confirm your understanding of

University policies, the Office of International Admissions asks that you

eview this form and complete the items on the bottom. Also, please review

your acceptance letter CAREFULLY! It contains important information you

ust verify. If you have any questions, please contact Fairleigh Dickinson’s

Office of International Admissions by calling the telephone number listed

on the reverse side or send an e-mail message to [email protected].

Registration: In order to register for classes, students must submit official

test scores (sent directly from the testing agency), final official transcripts of

course work currently in progress and/or course work that will be completed

prior to enrollment and diplomas/provisional certificates to FDU prior to the

start of the semester.

Tuition Deposit: A $200 non-refundable tuition deposit is required for all

new students as a means of verifying their intention to attend Fairleigh

Dickinson. Payment is due on the date indicated in your letter of admission.

The deposit guarantees a place in the entering class in the indicated major/

program and is applied to the first invoice for tuition and fees. It is considered

a service fee covering the administrative cost of the matriculation process

and is not refundable should a student fail to register and/or enroll for the

term accepted, unless the student is denied an FDU visa. See the "Visa

Rejection" section of this form for details.

Please fill out both sides of the yellow copy of this form, clearly indicating the

method of payment that you have selected. You may attach your check, bank

draft or money order to this form and submit both the form and the payment

to the Office of International Admissions by mail. Alternatively you may scan,

fax or mail the matriculation form to us and make a payment by credit card

or wire transfer. Retain the white copy of the matriculation form for your

records.

Housing: If you have been accepted as either a resident or commuter student

and you would like to request a change in this status, make your request in

writing to the Director of International Admissions at [email protected]. To

confirm your resident student status for the academic year, please include a

$350 non-refundable room deposit in addition to your $200 tuition deposit.

The $350 room deposit is applied to the first invoice for housing. University

housing is available to newly-admitted students on a first-come, first-served

basis. Please follow the instructions included in your admission packet to

submit the Housing and Meal Plan application. Submission of the housing

application and non-refundable deposit signifies a commitment to on-

campus housing for one academic year (fall and spring semesters only).

Meal Plan: All students residing on campus are required to participate in a

meal plan for the fall and spring semesters. Details of this program, which

includes vegetarian meals, will be forwarded automatically to all resident

students. Commuter students are not required to select a meal plan, but may

do so if desired. Commuter students interested in learning more about this

option should call the Dean of Students Office at +1-201-692-2190

(

Metropolitan Campus, Teaneck, NJ) or +1-973-443-8935 (Florham Campus,

Madison, NJ).

International Student Orientation: Students who have verified their

intention to attend Fairleigh Dickinson by paying their tuition deposit are

REQUIRED to attend orientation in order to begin their transition to the

niversity. At orientation, immigration documents will be collected and visa

rules and regulations will be discussed. In addition, new students will take

placement exams, have photographs taken for I.D. cards, meet with their

academic advisor, meet other members of the University community, and

complete many of the administrative details connected with enrollment.

New Student Orientation information will be sent by e-mail to deposited

students prior to their arrival on campus.

Health Forms: Please carefully read the instructions included with the

enclosed health forms. New Jersey state law requires that these forms be

submitted to the Office of International Admissions before a student checks

into the residence halls or registers for classes. No exceptions will be granted.

Questions about completing these forms can be answered by calling the

Wellness Center/Student Health Services Office at +1-201-692-2437

(Metropolitan Campus) or +1-973-443-8535 (Florham Campus).

Academic Regulations: The student is responsible for knowing the official

rules and regulations of Fairleigh Dickinson University. Enrollment is

considered an acceptance of all the conditions specified. Fairleigh Dickinson

reserves the right to exclude, at any time, students whose conduct or

academic standing does not meet the standards set forth in the University

Bulletin or Student Handbook. In such cases, any fees paid in advance to

Fairleigh Dickinson will not be refunded or remitted in whole or in part.

Financial Obligations: The Board of Trustees of Fairleigh Dickinson

University has adopted regulations governing the payment of tuition and

fees. Students pay their bills with this understanding. Students who have not

paid their bills on the due date may be withdrawn. The rules for refund of

tuition and fees upon withdrawal from the University are explained fully

in the University Bulletin.

Tuition and Resident Deposit Form: Please fill out the reverse side of the

yellow form and submit your required deposit. Resident students must also

complete the Housing and Meal Plan application form.

Visa Rejection: In the event that your FDU visa has been rejected based on

your FDU I-20, you will receive a full refund of deposits upon written request

and documentation of the rejection. Requests must be submitted prior to the

start of the semester. Requests received after the start of the semester will be

refunded in accordance with the University refund policy found at

fdu.edu/enrollmentservices (then click on Withdrawals, Cancellations,

Refund Policy)

Tuition and Resident Deposit Form

DEPOSITS REQUIRED AMOUNT ENCLOSED

Commuter Student $200 Tuition Deposit

Resident Student $

200 Tuition Deposit

$350 Room Deposit

TOTAL

Deposit Payment Options (Check one)

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Option #1 – Check, Bank Draft or Money Order

Attach a check, bank draft or money order (payable in U.S. dollars) to “Fairleigh Dickinson University” for the tuition deposit

and residence hall deposit (if applicable) to the yellow copy and return to Fairleigh Dickinson’s Office of International

Admissions. Please retain the white copy for your records.

■

Option #2 – Wiring Funds to Fairleigh Dickinson University

IMPORTANT: All wire transfers must include the student’s full name and 7-digit admissions identification number.

That number is provided on the admission letter.

You may route your payment via either of the following methods: Flywire

Go to: flywire.com/pay/fdu

Create a Flywire log-in and follow the steps

to fill out your payment details.

TD Bank

6000 Atrium Way

Mount Laurel, NJ 08054

FDU General Operations Accounting #7867442290

ABA Routing #031201360

If you encounter any problems with the wire transfer, contact the University’s Bursar at +1-201-692-2214. Once you have

completed the transfer, please scan, fax or mail the matriculation form to the Office of International Admissions.

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Option #3 – Payment by Credit Card or Electronic Check

Tuition and residence hall deposits can be made by credit card (VISA, MasterCard or American Express) or via ACH (electronic

check). To do so, use the very first link (Deposit Only) on the following web page: http://www.fdu.edu/makeapayment. Using

the Deposit Only link will allow you to pay the deposit without a surcharge.

Once you have completed the payment, please scan, fax or mail the matriculation form and confirmation of payment

to the Office of International Admissions at the address listed below.

Office of International Admissions

Fairleigh Dickinson University

1000 River Road • T-KB1-01

Teaneck, New Jersey 07666 • USA

Voice: +1-201-692-2205 • Fax: +1-201-692-2560

Email: [email protected]

REV 2.18