A P P L I C A T I O N

F O R

T R A N S F E R

A D M I S S I O N

Biographical Information
Email your completed application to transferapp@mit.edu. Your application will not be processed until we receive your application fee or fee waiver request.
1

Please do not staple

Part 1

Kwak
Last/Family name

Do Yong
First/Given name Middle initial

06/20/91
Date of birth ( Month / Day / Year )

2  Applying for term beginning in: February 2014

3  Have you applied before for admission to MIT?

Yes If yes, check appropriate boxes, and include month and year. Freshman_______________ Were you offered admission? Yes No No

No

(U.S. citizens and Permanent Residents only) Application deadline is November 15. Application deadline is February 15.

September 2014

Transfer_________________ Were you offered admission? Yes

4 B I O G R A P H I C A L I N FO RMATIO N

Kwak Do Yong Applicants legal name____________________________________________________________________________________________________________

Last/Family name First/Given name Middle Suffix (Jr., III, etc.)

Daniel Applicants preferred first name ___________________________________

South Korea Place of birth_________________________________________________

Female

Male

06/20/91 Date of birth __________________________

Month / Day / Year

5 ADDRESSES

The Office of Admissions will send all correspondence to your home address unless you specify a preferred mailing address. Please notify us if your address changes.
Home (permanent) address

120 east 12th Street #1508B

Street address

New York
City

NY
State or province _

10003
Zip or postal code

United States dyk254@stern.nyu.edu

Country

Area or country code

+1

(646) 334-3953
Telephone

Email address

Mailing address (if different from your home address)

Mailing address is valid from: _____________ through _____________

beginning date ending date

Street address

City

State or province

Zip or postal code

Country

Area or country code

Telephone

Massachusetts Institute of Technology | Transfer Admissions 77 Massachusetts Ave Room 3-103(T) Cambridge, MA 02139 Tel: 617.253.3400 mittransfer@mit.edu

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Part 1

Biographical Information Continued

6 C I TI Z E N S H I P I N F O RMATIO N

Kwak
Last/Family name

Do Yong
First/Given name Middle initial

Choose one option below. U.S. Citizen U.S. Permanent Resident (Green Card holder) Country of citizenship________________________________ Attach a photocopy of your Green Card.
7 ETHN I C I T Y I N F O R M ATIO N (optional)

Non-U.S. Citizen/Non-U.S. Permanent Resident

South Korea Country of citizenship________________________________ F-1 Visa Type (if applicable)______________________________

(F-1, J-1, etc.)

U.S. citizens and Permanent Residents only. In connection with its Affirmative Action Plan, the Massachusetts Institute of Technology guarantees equal opportunity in education to students of all racial and ethnic backgrounds. I consider myself to belong to the following ethnic group(s) (check all that apply): 1.) Are you Hispanic or Latino? Yes, Hispanic or Latino (including Spain) Which best describes your background? Central America Cuba Mexico Puerto Rico South America Spain Other__________________________ No
<< CLEAR

2.) Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member. American Indian or Alaska Native (including all Original Peoples of the Americas) Which best describes your background? Alaska Native Chippewa Choctaw Cherokee Navajo Sioux Other__________________________ Are you registered? No Yes, my registration number is__________________________ Asian (including Indian subcontinent and Philippines) Which best describes your background? China India Japan Korea Pakistan Philippines Vietnam Other East Asian________________________ Other Indian Subcontinent________________________ Other Southeast Asian__________________________
8 ED UC AT I O NA L H I S TORY

Black or African American (including Africa and Caribbean) Which best describes your background? African American Caribbean African Other__________________________ Native Hawaiian or Other Pacific Islander (Original Peoples) Which best describes your background? Guam Hawaii Samoa Other Pacific Islands (excluding Philippines)_____________________ White (including Middle Eastern) Which best describes your background? Europe Middle East __________________________

List the secondary schools (high schools) you have attended (if more than one, put most recent one first): ___ ___ ___ ___ ___ ___ _____________________________________________________________________________________________________
College Board school code (6 digits) Name City State or province Zip or postal code Date entered Date graduated

___ ___ ___ ___ ___ ___ _____________________________________________________________________________________________________

College Board school code (6 digits) Name City State or province Zip or postal code Date entered Date departed

List the colleges, universities, technical institutes, or community colleges you have attended or are attending (if more than one, list current one first): ___ ___ ___ ___ ___________________________________________________________________________________________________________
College code Name City State or province Country Date entered Date left Degree (if any)

___ ___ ___ ___ ___________________________________________________________________________________________________________

College code Name City State or province Country Date entered Date left Degree (if any)

___ ___ ___ ___ ___________________________________________________________________________________________________________

College code Name City State or province Country Date entered Date left Degree (if any)

Massachusetts Institute of Technology | Transfer Admissions 77 Massachusetts Ave Room 3-103(T) Cambridge, MA 02139 Tel: 617.253.3400 mittransfer@mit.edu

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Part 1

Biographical Information Continued

9 FA M I LY I N F O R M AT I O N

Kwak
Last/Family name

Do Yong
First/Given name Middle initial

a) Parent 1/Mother:

Living?_

Yes

No

b) Parent 2/Father:

Living?_

Yes

No

Last/Family name First Middle

Last/Family name First Middle

Occupation Employer Country of birth High school graduate? Yes No Name of university, if any________________________________________ Degree_________________________ Year______________________ Name of professional or graduate school(s), if any________________________________________ Degree_________________________ Year______________________

Occupation Employer Country of birth High school graduate? Name of university, if any Yes No

Degree__________________________ Year_______________________ Name of professional or graduate school(s), if any Degree__________________________ Year_______________________

c) Parents marital status Separated ___________

Date separated

Married

Never Married
Date divorced

Widowed

Divorced __________________________

f)  If any family members have attended MIT, check the boxes below, give names, class years, and relationship to you.

mother

father

grandparents _________
# attended

siblings_________
# attended

d)  If your legal guardian is someone other than your parent, list name, address, relationship and occupation. g)  If any family members are employed by MIT, give name(s), relationship to you and position at MIT.  e)  What is the primary language spoken in your home?

h)  If any family members serve as an Educational Counselor (MIT alumni interviewer), give name(s) and relationship to you. 

10 In what MIT academic department do you propose to register?________________________________________________________________________

I have completed all the applicable spaces on this form and I affirm their accuracy. I understand that any misrepresentation of facts on this form may be cause for refusal or cancellation of admission. By entering your name below, you agree that your typed name is your binding electronic signature.

Name (Signature)

Date

Check here if you plan to apply for financial aid. Note: For clerical use only. Financial need has no bearing on admissions decisions. Checking this box allows Student Financial Services to assist you in completing your financial aid application.
Massachusetts Institute of Technology | Transfer Admissions 77 Massachusetts Ave Room 3-103(T) Cambridge, MA 02139 Tel: 617.253.3400 mittransfer@mit.edu