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Application Form

Applicant Type

Citizenship and Eligibility

Agent/Recruiter Details

Last Name of counsellor submitting this application

First Name of counsellor submitting this application

Email address of counsellor submitting this application

Include +Country Code and Area Code

Include +Country Code and Area Code

Leave this field blank if you are a student, or if you are an agent and do not know your agency's code. 

Program Selection

UMass Boston GSSP

Refer to this website's program pages or brochure to find intake months for your selected program
University of Massachusetts Boston

Personal and Contact Details

Student Personal Details

Proof of Citizenship

Student Contact Details

Include +Country Code and Area Code

Family Background

Father's Details

Mother's Details

Emergency Contact

Include Country Code

Include Country Code and Area Code

Include Country Code and Area Code

Education Background

Secondary Education

Entry Date
Completion Date
Entry Date
Due to Completion Date

Post-secondary and Further Education

Entry Date
Graduation Date
Entry Date
Expected Graduation Date

English Test

e.g. IELTS, TOEFL, Pearson, 十大外围足彩网站, University

Current English Language School

Extra Information

Information of persons who may pay fees on your behalf

Provide the following details of that person(s):

Personal Statement

If you answer ‘yes’ to either of the below questions, please submit statements (in your own words) in documents which explain the circumstances, including approximate dates.

Form I-20

Employment History

If you believe you have employment experience that is relevant to the program you are applying for, please attach documents related to your employment history.

Airport Reception

Request for Learning Support

If there is anything that may affect your learning (for example, 损伤你的移动, sight, hearing, reading or writing), please notify UMass Boston so we can determine our ability to accommodate you. Please indicate your needs below.

Medical Insurance Requirements

I understand UMass Boston will provide a mandatory 12 months of medical coverage upon my arrival in the United States, at a cost of U$1,902. At the end of 12 months I will be required to extend the initial coverage. This fee changes annually and is correct at the time of printing.

Sponsored Students Only

e.g. Tuition Fees and/or living expenses

Declaration and Certification of Finances

The declaration and certification of finances is required of all international applicants to the University of Massachusetts Boston applying for a student visa (F1 or J1) and must be submitted along with the application for admission.

Extra Attachments

If you have other documents that you would like us to consider in your online application (e.g. transcripts/qualifications/awards), please attach them below.

Other Information

Ethnic Origin

This section is optional as the information collected is used for statistical purposes only.

Conditions, Disclaimer and Declaration

Conditions of Enrollment




Any information pertaining to your application to study, ongoing academic progress, results and attendance will be automatically provided the your parent(s), guardian(s) or recruiter.

(For the parent/guardian) As the parent/guardian of the applicant, do you declare that the applicant's submitted details, to the best of your ability, are correct?

Applicant Declaration

I declare that the information I have supplied on this form with respect to my application to UMass Boston Global Student Success Program is, to the best of my understanding and belief, complete and correct. I understand that giving false or incomplete information may lead to the refusal of my application or cancellation of enrollment. I have read and understand the published course information in the brochure or website and I have sufficient information about UMass Boston Global Student Success Program to enroll.


I give UMass Boston Global Student Success Program permission to obtain official records from an educational institution attended by me. I grant UMass Boston Global Student Success Program permission to provide UMass Boston with any information pertaining to my application of study, my ongoing academic progress, and my results and attendance for the purposes of admission and transfer. I understand that UMass Boston Global Student Success Program may collect, store and use personal information only for the purposes of administering prospective, current and graduate student admissions, enrollment and education, and that the information collected is confidential and will not be disclosed to third parties without my consent, except to meet government, legal or other regulatory authority requirements. For further information consult UMass Boston Global Student Success Program’s Privacy Policy and UMass Boston’s Access to Information and Protection of Privacy Policy at Policies and Procedures. I understand that after I commence my studies with UMass Boston Global Student Success Program, I will need to successfully complete the program and maintain the minimum required GPA before I can continue my studies at UMass Boston. I understand that if I have applied through an approved UMass Boston or UMass Boston Global Student Success Program recruiter, any information contained in my UMass Boston Global Student Success Program application may be released to that recruiter.


I understand that fees may change without notice. I accept liability for payment of all fees as explained in this brochure, and I agree to abide by the Refund Policy, which is current at the time of my studies at UMass Boston Global Student Success Program. I understand that living expenses in the United States may be higher than in my own country and I confirm that I am able to meet these costs. I understand that by submitting this online application, I will be eligible for consideration to be accepted to UMass Boston Global Student Success Program.


By submitting my details through this form, I also agree to this website's Terms and Conditions and Privacy Policy.