Fillable DVC International Student Application (Diablo Valley College)

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DVC International Student Application (Diablo Valley College)

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The DVC International Student Application (Diablo Valley College) form is 7 pages long and contains:

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  • 12 check-boxes
  • 97 other fields

Country of origin: US
File type: PDF

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International Student Admission Application
Required Documents
ALL applicants must submit the following:
2. Copy of passport ID page
3. Proof of nancial support
4. Proof of English prociency
Submit complete application and all required documents in PDF format by email to intlapp@dvc.edu
Transfer Students
Applicants currently at a US school must submit:
Copy of current SEVIS I-20
Copy of F-1 visa
Note: DVC only accepts SEVIS records in acve status
Minor Students
Minimum age is 16. Applicants under 18 years of
age by the me classes begin must submit:
Authorization for Minor Form
(See Page 6)
Student Consent for Release of Information Form
(See page 7)
Ocial high school transcripts showing proof of high
school graduaon. IGCSE and O Level ocial results
only: Preliminary results and/or independent/private
candidate results not accepted (records must show 5
subjects passed with C or higher including English:
rst language, second language or English language)
Expenses
$7,728
$8,174
$1,854
$1,234 Transportaon
$3,006 Miscellaneous and Personal
$1,332 Mandatory health insurance fee
English Proficiency
English Prociency Tests: ITEP score 3.5+
TOEFL iBT score 61+ IELTS score 5.5+
CAE Advanced 160+ Step Eiken 2A+
PTE score 45+ GTEC CBT score 1100+
Partner Intensive English Program Compleon:
Internaonal Educaon Center (IEC@DVC) Advanced B
ELS Language Centers Level 109
UC Davis IEP Level 600, 3.0GPA, B or higher in Composition
Transcripts showing 1 year of academic coursework taught
in English with passing nal grades: US school, IGCSE or
O level results, English medium school, IB diploma
Note: Proof of English proficiency must be within 2 years. Only scanned
copies of official document will be accepted.
The International Student Office (ISO)
Email: iso@dvc.edu
Website: www.dvc.edu/international
Phone: (925) 969-2196
1
In
t
er
national
Stud
e
nt
Off
i
ce
(ISO)
321 Golf Club Road, Pleasant Hill, CA 94523
925-
929-2200 www.dvc.edu
321 Golf Club Road, Pleasant Hill, CA 94523 925-929-2200 www.dvc.edu
International Student Admission Application
Spring Semester
Begin Processing Applicaons: September 20, 2019
Applicaon Deadline: November 1, 2019
In-Person Orientaon: January 23, 2020
Classes Begin: January 27, 2020
Classes End: May 22, 2020
Fall Semester
Begin Processing Applicaons: March, 2020
Applicaon Deadline: June 1, 2020
In-Person Orientaon: August, 2020 (TBD)
Classes Begin: August, 2020 (TBD)
Classes End: December, 2020 (TBD)
Spring Academic Bridge Program
Begin Processing Applicaons: December, 2020
Applicaon Deadline: January 31, 2020
In-Person Orientaon: Feb 26 & 27, 2020
Classes Begin: March 2, 2020
Classes End: April 30, 2020
1. Submit Application
Submit your application and documents in pdf
format to intlapp@dvc.edu. You will receive an
email regarding the status of your application within
15 business days.
2. Admission & I-20
You will receive an email regarding admission and
mailing of your I-20 (invitaon to study).
3. Online Orientation & Education Plan
You must complete the online orientaon and student
educaon plan to receive a priority registraon date.
4. Pay SEVIS Fee
You must pay your SEVIS fee before your visa interview.
Keep a copy of your receipt of payment.
5. F-1 Visa
You will go to the US Embassy/Consulate in your home
country and apply for your F-1 visa.
6. Register for Classes
You are required by law to register in and maintain
at least 12 units during Fall & Spring semesters and
exactly 6 units for Academic Bridge Programs.
7. Arrive in US
New students can enter the US up to 30 days before
the program start date on their I-20.
8. Attend In-Person Orientation
You are required to aend the In-Person Orientaon.
Summer Academic Bridge Program
Begin Processing Applicaons: April, 2020
Applicaon Deadline: May 22, 2020
In-Person Orientaon: June 25, 2020
Classes Begin: June 29, 2020
Classes End: August 20, 2020
Visit the Study in the States website for more
informaon about F1 student visas and immigraon
regulaons pertaining to F1 internaonal students.
hps://studyinthestates.dhs.gov
2
In
t
er
national
Stud
e
nt
Off
i
ce
(IS O)
321 Golf Club Road, Pleasant Hill, CA 94523 925-969-2196 www.dvc.edu
In
t
er
national
Stud
e
nt
Off
i
ce
(ISO )
Term applying for: Year:
Student Contact Information
Name (as appears on passport):
Family name:
First Name:
Middle:
Date of Birth (MM/DD/YYYY):
Gender:
Country of Birth:
Citizenship:
Student's Email:
Dependents
(legal spouse and children under theageof 21 if requiring F-2 status--must include copy of passport):
Last (Family name):
First Name:
Date of Birth (MM/DD/YYYY):
Country of Birth:
Citizenship:
Last (Family name):
First Name:
Middle:
Date of Birth (MM/DD/YYYY):
Country of Birth:
Citizenship:
Home Country Address:
Street Address:
City:
State/Province:
Country:
Home Country Phone Number:
US Address
(if known—required for transfer students):
Street Address:
City:
State/Province:
US Phone Number:
Agent Contact Information
(if applicable)
:
Agency Name:
Email Address:
Street Address:
City:
State/Province:
Country:
Phone Number:
Emergency Contact Information:
Full Name:
Relationship:
Street Address:
City:
State/Province:
Phone Number:
Email Address:
321 Golf Club Road, Pleasant Hill, CA 94523 925-969-2196 www.dvc.edu
3
Fall Semester
Female
In
t
er
national
Stud
e
nt
Off
i
ce
(ISO)
Additional Student Information
Academic Goal
(refer to https://www.dvc.edu/academics/programs.html for list of Certificate and Degree Programs ):
What is your academic objective?
What is your Major/Field of Study?
How do you meet the English proficiency requirement?
I learned about DVC and/or the Bridge Program through:
Website Counseling Agency Fair or Seminar Advertisement Friend or Relative Other:
Housing:
Students are responsible for making housing arrangements. Please refer to www.dvc.edu/international for local housing resources.
Immigration Status (if currently in the United States):
Are you an F-1 student studying in the US?
Name of current school:
SEVIS number: N
Last date of attendance:
Will you leave the US before transferring?
Date leaving the US:
If not in F-1 status, what is your current
status?
Do you plan to do a Change of Status in the US?
*Seeking guidance from an immigration lawyer or scheduling an appointment with an ISAS
advisor is highly recommended prior to submitting your application.
Educational Background Required
List the high school, college/university or language school you have attended
(list most recent first):
School/College Attended
City/Country
From(mm/dd/yyyy)
To(mm/dd/yyyy)
Diploma/ Degree
Financial Certification
The Department of Homeland Security requires certification of available funds to cover all expenses related to living and studying in the
United Sates for a minimum of one year. I certify that the total amount of funds that I have available for each year of study at
Diablo Valley College is $23,328 If you have a dependent requiring F-2 status, an additional $5,000 per dependent must be shown on the
bank statement. I plan to obtain funds to pay expenses while studying in the United States from the following source(s):
S
el
f-Su
p
po
rted
S
t
u
d
en
t
Pro
vid
e
a
rece
n
t
ban
k
s
tateme
n
t
in En
g
lish showing at l
e
as
t
$23,328
o
r
e
qui
vale
nt in liquid funds. Must have student’s n
ame
lis
te
d as
t
h
e
acc
oun
t
hold
e
r and be dated within the past 6 months.
Su
p
po
rted
Stu
d
en
t
(financial document may not be checking account)
In
c
lud
e
sponso
r'
s
rece
n
t
bank s
tateme
n
t
in English showing at l
e
as
t
$23,
328 or
e
qui
vale
nt in liquid funds. Must have sponsor’s name listed as
the account holder and
be
dated
within
the
past
6
months
.
Sponsor’s
Name:
Street Address:
City:
State/Province:
Country:
Postal
Code:
Relationshipto student:
I learned about DVC and/or the Bridge Program through:
321 Golf Club Road, Pleasant Hill, CA 94523 925-969-2196 www.dvc.edu
4
Complete Certification of Achievement
TOEFL IBT Score 61 or higher
No
No
No
In
t
er
national
Stud
e
nt
Off
i
ce
(ISO)
Application Fee
Fall/Spring Applicants:
Bridge Program Applicants:
$50 non-refundable application fee (required)
$50 non-refundable application fee(required)
$400 non-refundable deposit (collected by IEC@DVC)
To pay the required fees listed above, please fill out the credit card information below. We accept Visa and Mastercard.
By entering your credit card information, you are authorizing DVC to make the required charges to your credit card.
Credit CardNumber:
_
_
Expiration Date:
Cardholder Name:
F-1 Student Conditions Agreement
Diablo Valley College requires that you certify your application by submitting an electronic signature. To certify
your application, read the text blow and provide an electronic signature (type your name) below:
As an F-1 status student at DVC, I understand that I must fulfill the following conditions:
• Upon arrival, attend a mandatory F1 check-in session
•
Be enrolled in a minimum of 12 units each semester and maintain a cumulative grade point average of 2.0 or better
•
Have sufficient scholastic preparation and English proficiency to successfully participate in all coursework
•
Pay tuition and enrollment fees in full each semester
• Pay the mandatory health insurance fee at the beginning of each semester
•
Have sufficient funds to cover personal expenses and living arrangements
•
Update address with ISO within 10 days of moving
•
Be responsible for knowing and abiding by Contra Costa Community College District student code of conduct
“I hereby certify that all information provided on this application is true and correct. I understand that the presentation of false
information or failure to comply with DVC's admission and registration procedures may result in my dismissal without a refund of any
fees paid. I understand that if I am applying through an agent, the college may release information about my application status to
the agent.”
Electronic Signature:
Date:
Submitting Your Application & Receiving I-20 Upon Admission
Save your completed application as a PDF and submit it with the required documents by e-mail to
intlapp@dvc.edu. Upon submission, you will receive an automatic reply to confirm application receipt. See first page
of this application for filing and notification dates.
General inquiries can be sent to ISO@dvc.edu
Admitted students will receive an email once DVC I-20 has been created with the following options:
- Pick up I-20 from ISO office
- Mail I-20 (domestic or international) via EShipGlobal (instructions will be included).
If agent is listed on application, agent will be included in this email.
$50 non-refundable application fee (required)
$400 non-refundable bridge deposit (collected by IEC@DVC)
_
321 Golf Club Road, Pleasant Hill, CA 94523 925-969-2196 www.dvc.edu
5
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Parent or Guardian Authorization For a Minor Student to Attend DVC Form
For applicants younger than 18 years of age (at the start of classes) the following form must be on file
in the International Student Office in order for the student to be granted admissions:
I, _____________________, am the parent or legal guardian of the minor, ___________________________,
(Parent/guardian’s name) (Student’s name)
who is applying for admission as an international student at Diablo Valley College. I understand and agree that as
the parent/legal guardian of the minor, I am and remain financially responsible for the mandatory health
insurance required for all international students. I will promptly pay any invoice for the cost of such care (not
covered by the insurance). I also grant permission for any necessary medical treatment of the minor while
attending Diablo Valley College.
I understand that Diablo Valley College requires that minor students live under the supervision of a host family
for the minimum two month requirement. Students may also show that they are living with family or friends of
family in the area. I understand that the college and district have no legal responsibility for the care or well-
being of the minor student wherever he or she chooses to live while in the U.S. attending Diablo Valley College. I
also understand that the college and district have no relationship with any homestay company and assumes no
responsibility for the action 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.
Diablo Valley College requires that you certify your authorization by submitting an electronic signature. To
certify your application, provide an electronic signature (type your name) below.
_______________________________ _____________________
Parent/Guardian Date
In
t
er
national
Stud
e
nt
Off
i
ce
(ISO)
6
321 Golf Club Road, Pleasant Hill, CA 94523 321 Golf Club Ro 321 Gol 321 Golf Club Road, Pleas
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signature
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STUDENT CONSENT FOR RELEASE OF INFORMATION
STUDENT WITHDRAWAL OF CONSENT FOR RELEASE OF INFORMATION
_____________________________________ ______________________________
Student Name (Please Print) Student ID#
The Family Educational Rights and Privacy Act (FERPA) of 1974, as amended, seeks to guarantee both a
student’s right of access to education records and the confidentiality of student information.
Institutions may not disclose information contained in education records without the student’s written
consent except under certain conditions. A student’s record may be released to parents, guardians or
other third parties by providing a written authorization or consent.
STUDENT CONSENT FOR RELEASE OF INFORMATION
I hereby give my consent for my parents, guardian or other third party, as named below, to have access
to my education records. I understand that each individual will need to show a valid photo ID at the
time of release to view my records.
_____________________________________ ____________________
Student’s Signature Date
One time only. This box must be checked if you wish this to cover a one-time only release.
Parent/Guardian/Third Party (Please Print)
1) _____________________________________ ________________________
Name Relationship
2) _____________________________________ ________________________
Name Relationship
3) _____________________________________ ________________________
Name Relationship
STUDENT WITHDRAWAL OF CONSENT FOR RELEASE OF INFORMATION
I hereby withdraw my consent for my parent, guardian or other third party as named above, to have
access to my education records, effective immediately. If I wish to reinstate the consent for release of
information, I understand that I will have to complete another form at that time.
_____________________________________ ____________________
Student’s Signature Date
321 Gol 321 Golf Club 321 Golf Club RoRoad, Pleas 321 Golf Club Road, Pleasant Hill, CA 94523
In
t
er
national
St
ud
e
nt
Off
i
ce
(ISO)
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DVC International Student Application (Diablo Valley College)

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Completed 18 July 2020

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