Fillable Additional Questions for International Students Applicant Information Student (Erie Community College)

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Additional Questions for International Students Applicant Information Student (Erie Community College)

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1 | Page
Additional Questions for International Students
Applicant Information
Student Na
me:
__________________________________________________________________ Date: ___________________________
First name Middle Name Last Name
Country of Cit
izenship: __________ Country of Birth: _______________ City of Birth: _____________
Email: _______________________________________ Primary Language: ________________________
Please select your current intended visa Status:
☐Visa Holder Type of Visa: ________________
☐Applying for a Student Visa (F-1 visa)
Are you cur
rently in the United States? _____________
Currently Holding F-1 Visa
Name of I
nstitution with F-1 visa Status: ____________________________________________________
Visa Issue Date
: ______________________________ Visa Expiration Date: _________________________
Is your F-1 v
isa presently out of status? ____________________________
English Proficiency Exam (such as TOEFL)
If you have taken or scheduled to take an English Proficiency Exam, please select one of the following:
☐TAKEN an English Proficiency Exam
☐SCHEDULED to take an English Proficiency Exam
☐NOT taken and NOT scheduled an English Proficiency Exam
Which exa
m did you or do you plan to take?
☐TOEFL IBT
☐TOEFL Comp
☐TOEFL Paper
☐IELTS
What date
did you take or plan to take the English proficiency exam? _____________________
2 | Page
Emergency Contact Information
Emergency Contact: ___________________________________________________________________
Relationship to Applicant: _____________________
Phone Number: _________________________
Street Address
Line 1: _________________________ City: __________________________________
Street Addres
s Line 2: _________________________ Postal Code: ____________________________
Country: ____________________________________
Financial Support
Are you planning to come with dependents? _________________________________ (A dependent is
someone who would be traveling here and living with you and that you would be financially responsible
for, such as a spouse or child) If so, you will need to upload each dependent’s passport.
Dependent 1: ________________________________ Date of Birth: ___________________________
First Name Middle Name Last Name
City of Birth: ________________________________ Relationship: ___________________________
Dependent 2: ________________________________ Date of Birth: ___________________________
First Name
Middle Name Last Name
City of Birth: ________________________________
Relationship: ___________________________
Dependent 3: ________________________________ Date of Birth: ___________________________
First Name Middle Name Last Name
City of Birth: ________________________________ Relationship: ___________________________
Dependent 4: ________________________________ Date of Birth: ___________________________
First Name Middle Name Last Name
City of Birth: ________________________________ Relationship: ___________________________
First name Middle name Last Name
3 | Page
Autobiographical Essay
Instructions: all applicants must complete this section.
Please write a short paragraph outlining your academic goals at Erie Community College. Please include
the name of the
major that you wish to enroll. Also, please state whether you plan to transfer to another
4-year university in the U.S. or plan to return home.
Financial Support Continued
If not, list your financial sponsor and relationship below:
Financial Sponsor: ______________________________
Relationship: ___________________________
Are you a financial self-sponsor? ________________
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Additional Questions for International Students Applicant Information Student (Erie Community College)

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Completed 29 January 2021

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