International (F-1 Visa) Student Application

Transcription

International (F-1 Visa) Student Application
International Student Center · 1000 W Foothill Blvd, Glendora, CA 91741-1899 · (626) 914-8549 · FAX (626) 857-4182 · [email protected]
Citrus College is a community college known for its academic excellence and dedication to student success.
Students enjoy our small, friendly campus where they are our number one priority. Instructors and staff
are committed to helping make each student's experience at Citrus College exciting, challenging, safe, and
successful.
Citrus College is located in the foothills of the beautiful San Gabriel Mountains in the city of Glendora, just
26 miles from downtown Los Angeles. Glendora has been listed as one of the safest communities in
California and offers its residents a wonderful small town atmosphere. Citrus College is within a short drive
to beaches, mountains, Disneyland, Hollywood, Los Angeles, Beverly Hills, and famous cultural centers for
music, drama, and art. So whether students want to lie on the beach, go snowboarding in the mountains,
attend a Dodger baseball game, or just hang out with friends at Starbucks, Citrus College is never too far
away from fun and adventure.
The campus is also conveniently located just a short walk from restaurants, movie theaters, pharmacies,
grocery stores, clothing stores, banks, and apartments.
International Application Deadlines: (Both Academic and Intensive English [ESL] Terms)
Summer Session
Fall Semester
Spring Semester
Deadline to Apply: April 1
Deadline to Apply: July 1
Deadline to Apply: December 1
(Start Term: June)
(Start Term: August)
(Start Term: February)
International Applications must be submitted with an online CCCApply Citrus College application Student
ID Number and all other supporting documents listed on page two of this form.
Email Application To:
Mail Application To:
[email protected]
Citrus College: International Student Center
1000 West Foothill Boulevard
Glendora, California 91741-1899
(Attach individual documents in PDF format)
International Student Center
Phone: (626) 914-8549
Fax (626) 857-4182
Office Hours:
8AM – 5PM Monday/Wednesday/Thursday
8AM – 7PM Tuesday
Website:
8AM – 4:30PM Friday
http://www.citruscollege.edu/stdntsrv/international
ALL DOCUMENTS SUBMITTED TO CITRUS COLLEGE BECOME PROPERTY OF CITRUS COLLEGE AND WILL NOT BE RETURNED TO THE APPLICANT.
Page 1
International Student Application Requirements
Required Application Documents:
 International Student Application form (page 3)
 Photo (attach to international student application page 3 or email)
 CCCApply Online Application (for Citrus College ID Number)
o Forward ID Number to [email protected]
 $40 Application Fee (pay online through personal Wingspan account with ID number)
o ISC must have Citrus College student ID number to set up account online first
 Financial Guarantee Form with Sponsor’s Signature (or list “Self-sponsored;” page 4)
 Current Official Bank Statement (within 6 months)
o $18,580 USD (or equivalent) for Academic Program Option (with proof of English proficiency)
o $19,728 USD (or equivalent) for Intensive English Option (ESL; English proficiency not required)
 Health Form with Current Official Negative TB Test Results or Negative Chest X-Ray Results (page 5)
 Copy of Passport
Other Requirements:
 Academic Program Only: Official proof of English Proficiency (Minimum TOEFL 450/45, IELTS 5.0, two
years of high school in the US, official US college transcripts with a passed Academic English course, FLS Level 14
[Formerly 7b], ELS Level 109, IKEN Grade 2, Kaplan Higher Intermediate Level, Pearson 39, or ITEP 3.5)
Proof of English proficiency is NOT required for Intensive English Option (ESL) applicants.
 If under 18 years of age before the start date, you must provide proof of high school graduation:
o US High School: sealed official transcript proving graduation
o Foreign High School: we accept UCLA’s HS equivalent list or an official evaluation proving US high
school graduation equivalency (see Citrus College’s list of accepted transcript evaluation services)
 If under 18, you must have a parent/guardian fill out and sign the Minor Authorization form (page 7)
Transfer applicants with an active I-20 must submit all of the above, and in addition:
 Copy of F-1 Visa and I-94
 Copy of current/previous school’s I-20
 US Official Transcripts (must be submitted in sealed envelope –emailed copies not accepted)
o Foreign high school, foreign college, or language school official transcripts NOT required
 Transfer eligibility form/SEVIS release (page 10; with Citrus College acceptance letter)
Page 2
International Student Application Page
Applying for:
Fall
Spring
Summer
ATTACH
PHOTO
HERE
(or email photo)
Year
Citrus College Student ID Number: A00
Personal Information: (Full legal name as it appears on your passport)
Last Name (Family Name/Surname)
Male,
Middle Name (optional)
First Name
Female, DOB:
Country of Birth:
Citizenship:
Month/Day/Year
Email
Foreign Phone #
Foreign Mailing Address
City
Province/Territory
US Address (if available)
City
State
Postal Code
Country
US Phone # (if available)
Zip Code
Name of Parent/Legal Guardian (if under 18):
Phone Number:
Relationship:
Are you transferring an active I-20 from another US school?
No,
Yes:
Name of Current US School
Type of Visa you have currently:
F-1/Expiration Date of I-20:
,
None, Other
Check Which Option You are Applying for:
 College Academic Program (Specify Major):
 Intensive English Program (ESL)
(College Academic Program requires Proof of English Proficiency)
How were you introduced to Citrus College?





 Publications:
o Study in the USA
o Hotcourses
o Hobsons
o Other:
Friend
Relative
Internet
Student Fair (please specify):
School:
Educational Information: If a US high school graduate, write date of graduation:
School Name
City, State, Country
Dates Attended
Degree or Diploma
Page 3
Financial Guarantee of Support (Confidential)
Name of Applicant:
Last Name (Family Name/Surname)
First Name
Sponsor’s Information: (If sponsoring yourself, write “Self” under “Relationship” below.)
Relationship to Applicant (i.e. parent; or self)
Name
Sponsor’s Guarantee:
I guarantee that the funds stated below or on the current official bank statement (please attach) will be
available for the named applicant for the duration of the applicant’s enrollment at Citrus College or for a
minimum of two years, whichever is longer.
Signature:
Date:
Bank Verification
(To be completed by bank official within 6 months; or attach a current official bank statement instead)
Account Holder’s Information:
This is to certify that
has U.S. $
Name of bank account holder
USD or equivalent
on deposit at this bank:
Account #:
Date Opened:
Bank Address:
Bank Official’s Information:
Signature:
Date:
Bank Official’s Title:
Minimum Amount Requirements:
Official Bank Seal/Stamp Here


$18,580 USD (or equivalent) with Proof
of English Proficiency
$19,728 USD (or equivalent) without
Proof of English Proficiency
Page 4
Health Form & TB Test or Chest X-ray Results
To be completed by the applicant:
Name:
Last Name (Family Name)
DOB:
First Name
Gender:
Male,
Female
REQUIRED: Negative TB Test Results with Official Seal or Stamp; OR attach Official Results on Letterhead
1. Official Tuberculosis Test Results (within 6 months), PPD, Mantoux (Tine test not accepted)
Results
Date
If skin test is positive, applicant must submit a chest x-ray taken within the last six months.
Results
Date
2. Does the applicant have any condition (physical/mental) which would prevent or restrict
participation in a full course of study?
Yes
No
It is recommended that the following immunizations are also administered before entering the United
States: Diphtheria, Tetanus (within the last 9 years), and Hepatitis B (3 doses).
To be completed by the physician/official health representative:
Name:
Signature:
Official Seal/Stamp Here
Email
Phone Number
Date
Page 5
Emergency Contact Information & Certification
In case of an emergency, school officials are authorized to provide what they deem to be appropriate
emergency care by licensed physicians and hospitals or to provide treatment as needed.
Student's Signature (if student is over 18)
Parent or Guardian's Signature (if student is under 18)
Emergency Contact Name
Relationship to Applicant
Emergency Contact Phone Number
Email Address
Certification:
I hereby certify that all information presented in this application is true and correct. If accepted to Citrus
College, I agree to abide by all of the rules and regulations set forth by the college.
Signature of Applicant
Date
If under 18, Parent/Guardian’s Signature
Date
Name of Parent/Guardian (print)
Page 6
Parent/Guardian Authorization for a Minor (Under 18)
The following authorization form must be completed by a parent or legal guardian of the applicant if the
applicant is less than 18 years of age. A completed form must be on file in the International Student
Center before the student will be allowed to register for classes.
I,
, am the parent or legal guardian of the minor student
Print name of parent/guardian
, who will be/is enrolled as an international student at
Print name of applicant/student
Citrus College. I hereby authorize the employees of Citrus Community College District (District) to obtain
for the minor any immunizations, well care, medical and/or dental treatments, which in their judgement
are deemed necessary. I understand and agree that as the parent/legal guardian of the minor, I am and
remain financially responsible for all such immunizations, well care, medical and/or dental treatments
provided to the minor, and I will promptly pay any invoice for the cost of such care.
As the parent/guardian of
, I want the District to know about all current
medical problems, including psychological difficulties and serious allergies (animal, food, medicine) and
physical limitations of the minor child as follows:
As the parent/guardian of
, I want the District to have a complete list of all
medications that are currently being prescribed for the applicant/student as follows:
Frequency
Frequency
Frequency
I understand that the Citrus Community College District strongly recommends that minor students live
either with family or family friends, or under the supervision of a host family until they turn 18. I
UNDERSTAND THAT THE DISTRICT HAS NO LEGAL RESPONSIBILTY FOR THE CARE OR WELL BEING OF
THE MINOR STUDENT WHEREVER HE OR SHE CHOOSES TO LIVE WHILE IN THE U.S. ATTENDING
CITRUS COLLEGE. I ALSO UNDERSTAND THAT THE DISTRICT HAS NO RELATIONSHIP WITH ANY
HOMESTAY COMPANY AND ASSUMES NO RESPONSIBILITY FOR THE ACTIONS OF ANY HOST FAMILY OR
HOMESTAY COMPANY. I understand that in all legal issues, I am and remain responsible for the care and
guardianship of this minor student.
Signature of parent/guardian
Date
Page 7
Release of Information Form (Optional)
I,
, authorize
Printed name of applicant
to be
Printed name of person to receive information/documents
provided with information and pick up documents regarding my tuition payments, enrollment, grades,
and/or any other information and/or documents pertaining to my status as a student at Citrus College, if
required.
Date
Relationship to Applicant (i.e. parent)
Document Pickup ONLY Authorization Form (Optional)
I,
, authorize
Printed name of applicant
to
Printed name of person authorized to pick up documents
pick up information/documents on my behalf, such as my application acceptance documents (I-20,
acceptance letter, etc.), and/or any other documents I may require.
Date
For ISC Office Use Only:
Document Pickup
Item(s) Picked Up:
I-20,
AL,
Other:
Signature
Date
Page 8
Photo Release Form (Optional)
We enjoy posting pictures on our website and Facebook page, and would appreciate your consent to use
any potential photos of you having fun at our events and around campus:
International Student Center
CITRUS COMMUNITY COLLEGE DISTRICT
Division of College Advancement
Office of Development & External Relations
1000 W. Foothill Bvd., Glendora, CA 91741-1899
Tel: 626.914.8872
Name:
Release No.
Release
Adult/Minor
ID:
I hereby consent to and authorize Citrus Community College District, herein after called Citrus College,
permission to record my image and/or voice and grant Citrus College, or anyone authorized by Citrus
College, all rights to use these sounds, still, or moving images in any medium for educational, promotional,
advertising, or other purposes that support the mission of Citrus College. I agree that all rights to the sound,
still, or moving images shall constitute Citrus College’s property, solely and completely. I understand I will
not receive compensation for posing for these sound, still or moving images.
Signature:
Date:
Email:
Phone:
Approximate Tuition Fees Per Term (Fees subject to change)
International Student Tuition/Enrollment Fee
$287 per unit (12 unit minimum Fall/Spring = $3,444)
Health Service Fee
$19 per term
Student Service Fee
$15 per term
Citrus College Health Insurance
$612 per 6 months coverage
Total per Term (with minimum units)
$4,090 (approximately)
Students are personally responsible for the purchase of all books, materials and supplies needed for courses
(approximately $300 per term), as well as personal housing, food, and other necessities.
Page 9
I-20 Transfer IN to Citrus CollegeDate________________________
Eligibility Form
Student Name:
Rules and regulations as defined by the Immigration and Naturalization Service require that a student, in order to be
eligible to transfer to another school:
a)
Must have been pursuing a full course of study.
b)
Must have been in attendance during the term
immediately preceding the transfer or the term
preceding a vacation.
c)
If not in attendance, must have reported in person to
authorized school and applied for transfer for that
same term.
The above-referenced student has requested admission to Citrus College as a transfer student from your school. Please
complete this form and return it to the ISC as soon as possible. Do not transfer I-20 until a full Acceptance Letter has
been given. SEVIS Code: LOS214F00319000
ACTION REQUESTED:
1. Based on the above information, is this student eligible to transfer?
Yes
No
If no, why?
2. Does the student have any outstanding financial obligation at your institution?
3. Dates of attendance at your school: Start Date
4. Type of program:
ESL,
Undergraduate,
Yes
No
- End Date
High School, Other:
5. SEVIS Number
SEVIS Release Date
This form will serve as notification to you that the above student is transferring to Citrus College. Your completion of
this form is greatly appreciated. Please return by fax or email. Thank you for your cooperation.
___________________________________________________
School Name
School Stamp (optional):
Name of Student Advisor (DSO)
Signature
Email
Phone
Page 10

International (F-1 Visa) Student Application

Transcription

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