Application for Legal Studies Institute
Program for which you are applying:
Paralegal on Campus □
Legal Assistant □
English for Legal Professionals □
Online Paralegal □
Law Office Management □
Immigration for Paralegals □
Semester for which you are applying:
Spring □
Summer □
Fall □ 20__
Personal Information
(Please Print)
Name:_________________________________________
S.S. #:__________________________
Address:___________________________________________________________________________
City:_____________
State:_____
Zip:_________
Home Phone:_____________________
Employer Name and Address:__________________________________________________________
__________________________________________________________________________________
Highest Level of Education:_______________________
Email:___________________________
All information gathered in this application is subject to verification. Inaccuracy may affect your admission to the program.
Please Attach the Following:
- Copy of Your Resume
- Two (2) Letters of Recommendation
- Valid Driver’s License (copy must be legible)
- Current picture
- A $25 non-refundable fee (waived for FIU students, alumni and staff)
- IF you are applying for Financial Aid, and you are NOT a US citizen, you must provide evidence of your legal status
in the US
TO CONTACT US:
Please forward all documents to:
Tel: (305) 348-2491
Florida International University / Legal Studies Institute
Fax: (305) 348-2030
Modesto Maidique Campus, RDB 2015
Email: legal@fiu.edu
Miami, FL 33199
Web: lsi.fiu.edu
Payment Information - Application Fee $25
Check or Money Order No.________________________ (payable to FIU/Legal Studies)
Signature: ________________________________________ Date:_________________________
□ VISA □ MC □ American Express □ Discover
Account #:___________________________________________ Exp. Date ___________________
Billing Address: ______________________________________ City, State, Zip: __________________
Florida International University
Legal Studies Institute
Non-Credit Certificate Program
Note: If your name and address has changed since your last attendance at FIU, please notify the Legal Studies
Institute.
Important: Have you ever received a grade from FIU? Yes:
□
No:
Social Security Number (SNN) : |__|__|__| - |__|__| - |__|__|__|__|
□
Panther ID: ___________
Term:_________
Driver's License Number: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| (Attach a copy of DL)
Name: (Print, one character per block. Leave one block between names)
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Last Name
First Name
M.I.
Permanent Address
Number and Street
City
County
State
Country
Zip Code
City
County
State
Country
Zip Code
Local Address
Number and Street
Home Phone: __________________ Cellular: __________________ Work: _________________
Nation of Citizenship:_________________ Place of Birth: _________________ Birth Date:___________
Sex: Male:
□ Female: □
E-mail Address: _________________
Race: (Required by US Dept. of HEW under Title VI of the Civil Rights Act)
□ (B) - Black ( Not of Hispanic origin) □ (H) - Hispanic □
(I) - American Indian or Alaskan Native □ (W) - White (Not of Hispanic origin) □
Yes □ No □ Are you applying for Financial Aid 'Stafford Loan'? Financial Aid is available only in the
(A) - Asian or Pacific Islander
form of a ‘Stafford Loan’.
Institution where most course work of highest degree was granted:__________________________
Dates Attended:___________________ Highest Degree:________________ Date Received:__________
Failure to answer this question will result in a delay in processing your application
If your answer to any of the following is yes you must submit a full statement of relevant facts on a separate
sheet attached to this form. You may be required to furnish the university with copies of the official
documentation explaining the final disposition of the proceedings.
□
□
□
□
a.
Yes
No. Are you currently or have you ever been charged with or subject to disciplinary action
for scholastic or any other type of misconduct at any educational institution?
b.
Yes
No. Have you ever been charged with a violation of the law which resulted in probation,
community service, and jail sentence or the revocation or suspension of your driver's license (including traffic
violations: which resulted in a fine of $200 or more)?
If your records have been expunged pursuant to applicable law, you are not required to answer yes to these
questions. If you are unsure whether you should answer yes to a or b, we strongly suggest that you answer yes and fully
disclose all incidents. By doing so, you can avoid any risk of disciplinary action or revocation of an offer of admission.
Non US Citizen Students:
Alien Card Number or Visa Type:_________________ Date Issued___________ Expires: ______________
Notification of Collection and Usage of
Social Security Number from Students
of the Legal Studies Institute
Florida law provides that Florida International University (FIU) must notify students of
the purposes for which FIU collects social security numbers. This notice is to inform you
that with respect to the Legal Studies Institute, FIU collects social security numbers from
its students for the following:

For use in processing admission applications for purposes of identification and
verification of student records;

For use in administering federal and state programs/loans, including verification
of eligibility and reporting requirements. These programs include, but are not
limited to financial aid;

For use in providing official student transcripts to authorized third parties (i.e.
educational institutions and employers upon receipt of required releases) for
student identification purposes;
Please note that this is only a listing of the collection and use of social security numbers
by the Legal Studies Institute. All students are advised that social security numbers are
confidential and may only be released in accordance with applicable law.
Purpose
In order to comply with the Department
of Education Integrity Rules Program
requirements; to process reports to be
provided to other FIU Departments and
the Department of Education.
Statutory Authority
Fla. Stat. Sec. 119.071(5); 34
CFR § 668.6
By signing this document, you acknowledge the receipt of the above statement.
Name:
Signature:
Employee/Student Panther ID:
Date: