Bemidji State University
International Student Agreement
For International Student Application
PLEASE READ CAREFULLY BEFORE SIGNING THIS FORM.
I certify that I understand and accept the following conditions and agree to abide by them. As a condition to my admission,
I agree to the following:
I understand that this application and supporting documents become the property of Bemidji State University regardless of the
admission decision. As such, once the documents are received by the University, Bemidji State University will not return any
documents (the application and/or any supporting documents) to you, the applicant/student.
I understand that I am required to pay ALL tuition and fees (which includes mandatory purchase of BSU health insurance) by the
designated payment deadline date EACH semester. If I do not pay by the deadline date, I understand I will be prohibited from
registering for future semesters. By failing to register, I will have violated my immigration status.
I will have available sufficient funds for tuition, fees, health Insurance and living expenses for each year I study at Bemidji State
University. I recognize that the cost of living is high, that financial aid from the University is not available, and that as a general rule,
International students are not permitted to work off campus. There may be limited on-campus employment after successful
completion of orientation and registration.
I will take the Bemidji State University “English Placement Examination” before I will be allowed to register for academic studies and
fulfill the requirements that result from my score on the examination.
I acknowledge that I may be required to take a “Math Placement Examination.” Admission requirements to Bemidji State University
require that students provide evidence of college readiness either through the ACT, SAT or another assessment instrument.
Students who have tests older than three years and have not earned college credit in the area college mathematics must take
Accuplacer. I agree to fulfill the requirements that result from my score on the examination.
I am responsible for understanding the rules and regulations for being on a student visa in the United States.
I authorize Bemidji State University to release to any U.S. Government Officer information required to determine my compliance
with U.S. Homeland Security/Immigration Laws. Furthermore, I understand that the University will report all information required
by U.S. Homeland Security/Immigration (such as students who are not registered, are not pursing a full course of student or are not
meeting the minimum academic standards of the University).
I agree to purchase the Minnesota State Colleges and Universities System Health Insurance Plan as a condition of admission and
continued enrollment by the published due dates each year.
I agree to attend all the dates of the required new student Orientation sessions. I will arrive on or before the reporting date as
stated on the Admitted student letter and the I-20 or DS-2019 form.
I recognize that I will be charged a one-time $100 Orientation Fee my first semester at Bemidji State University.
I agree, as an undergraduate student new to the USA, to enroll in the course “First Year Experience for International Students”.
(Graduate students are exempt from this requirement).
I declare that all the information I have submitted for my application for admission is true, correct and complete.
I understand and will comply with the requirements as stated on this agreement. I understand that falsification of any information
will jeopardize the issuance of an I-20 or DS-2019 and/or may result in Bemidji State University revoking its decision to enroll me as
a student.
If I am a transfer student from another school in the USA, I will bring an up-to-date, current copy of my I-20 or DS-2019 form to be
given to the International Program Center upon my arrival at Bemidji State University.
Printed Name of Applicant: ____________________________ ____________________ __________________________
(Last or Family Name) (First or Given Name) (Middle Name)
Signature of Applicant: ________________________________________________________________________
(Required ) Date
International Admissions Email: international@bemidjistate.edu
Admission requirements and additional information can be found at
http://www.bemidjistate.edu/students/international/international_students/
INTERNATIONAL STUDENT AGREEMENT
For International Student Application
Signature of Applicant: ________________________________________________________________________
(Required) Date
