Fillable FHDA International Application F17

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FHDA International Application F17

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Foothill and De Anza Colleges
International Student Application
Thank you for applying to Foothill and De Anza Colleges. Once all the required documents are received, you will be issued an
ofcial immigration document and sent an acceptance packet. An orientation is mandatory for all new students and specic dates
will be included in your acceptance packet. During orientation you will be tested for English and math prociency.
Important Dates
Expenses
Admission Check List
Fall Quarter Winter Quarter
Spring Quarter
Classes begin
Application Deadline
Mandatory Orientation
Late September
June 30
Late August / Early September
Early January
October 31
Early December
Early April
January 31
Early March
The following estimated expenses are for one academic year
(three quarters not including summer):
Tuition and Fees (tuition fees are paid quarterly and are subject to change)
Tuition is based on $191.00/unit for 12 units minimum/quarter; many students take additional units
at $191.00/unit. Summer tuition and related expenses are not included.
Health Insurance - our insurance is required for all F-1 students
Estimated Living Expenses
Books and Supplies
Room and Board (homestay for 10 months at $1,200.00/month - information on page 3)
Spending Money
Total Estimated Cost
$6,876.00
1,518.00
1,500.00
12,000.00
2,500.00
$24,394.00
Students must be at least 16 years old AND have graduated from secondary/high school by the start of orientation
to be eligible for admission to Foothill and De Anza Colleges.
All application documents MUST be original or certied; no faxes, scans or copies are accepted.
Completed
1.
Complete, sign, and return this application form with a copy of the photo page in your passport.
2. Submit proof of English prociency. See page 4 for more information on minimum test scores.
3. Complete the Condential Financial Statement on page 3, which must be signed by the person
guaranteeing your nancial support. Submit an original bank letter dated within the last 6 months
with an ofcial signature on bank letterhead that veries the current balance in USD of your account
or your sponsor’s/ guardian’s account.
4. Submit original or certied English translations of your secondary and post-secondary transcripts.
5. Attach a recent photograph to page 2.
6. Submit a non-refundable credit card authorization for the 75.00 USD application fee and a non-
refundable 75.00 USD express mailing/courier fee to send your acceptance documents outside the U.S.
Download credit card authorization forms for the college to which you are applying from the websites:
www.foothill.edu/international/ad_applic.php | www.deanza.edu/international/admission.html.
7. Submit a Dependent(s) Information Form for spouse and child (if they plan to reside with you in the U.S.)
8. Apply and mail documents to only one college:
Foothill College
Attn: International Programs Ofce
12345 El Monte Road
Los Altos Hills, CA 94022, USA
Telephone 650-949-7293 • Fax 650-949-7080
Email: foothillinternational@fhda.edu
www.foothill.edu/international
De Anza College
Attn: International Student Programs
21250 Stevens Creek Blvd.
Cupertino CA 95014, USA
Telephone 408-864-8826 • Fax 408-864-5638
Email: dainternational@fhda.edu
www.deanza.edu/international
- 1 -
International Student Application
Legal Name
(As it appears on your passport)
(Family/Sur/Last)
(Given/First)
Preferred Name (Optional) Male Female
Applicant’s Home Country Address
(Number and Street)
(City)
(Province)
(Country)
(Postal Code)
United States Address (Number and Street):
(City)
(State) (Zip code)
Home Counry Telephone U. S. Telephone:
(Country code and phone number)
(Area code and phone number)
Student’s Email Address (required)
Country of Citizenship Country of Birth
What is your racial/ethnic background?
Are you under 18 years of age?
Date of Birth
(Month) (Day)
(Year)
Proposed major or eld of study
Two-year Associate’s Degree (A.A. or A.S.) Two-year Transfer Program
Please Print Clearly - This information will appear on the SEVIS Form I-20
issued by the Department of Homeland Security.
I am applying to attend
(check only one box):
Foothill College De Anza College
I plan to enroll for
(ll in the year):
Fall Quarter - September Spring Quarter - April
Winter Quarter - January Summer English - June/July
I plan to enter: from the U.S. from outside the U.S.
If you currently hold a valid U.S. visa in your passport please indicate the type:
B-2 F-1 J-1 Other U.S. visa:
Send my documents:
to the address in my home country to the address in the U.S.
to be picked up in the International Students Ofce
to the Agent’s address
If you are currently an F-1 student transferring from another school/college in the U.S.:
Name of school that issued your most recent SEVIS I-20:
Your SEVIS number:
Submit a copy of your current I-20, I-94 card, F-1 visa and passport, plus an ofcial transcript.
Ofce Use Only
Student ID:
Personal Information
No
Yes
MUST BE STUDENTS PERSONAL INFORMATION ONLY
(Students under 18 must complete a parental authorization form and submit it with
the application. See www.international.fhda.edu/ParentAuthorization.pdf)
Photo
-2-
Check the options at: www.foothill.edu/international/im_background.php
(If no major is indicated, Liberal Arts and Sciences/Liberal Studies will appear on I-20)
International Student Application
Applicant’s Legal Name
(As it appears on your passport) (Family/Sur/Last Name)
(Given/First Name)
I plan to obtain money for expenses while studying in the U. S. from:
Personal Savings
(Please sign below to certify)
Parent or Family Savings (Name)
U.S. Sponsor (Name)
Government Scholarship
Other source
(If a sponsor, list name and relationship)
I certify that I will have a minimum of $24,394.00 U.S. dollars for each year of my study exclusive of travel expenses
Additional information
Condential Financial Statement
Certifying Statement
-3-
Sponsor’s or Guardian’s Name (printed)
Address of Sponsor or Guardian
(Number and Street)
(City) (State/Province)
(Country) (Postal Code)
Signature of Sponsor
Date
Relationship to Applicant
Important Information
You must include the following document in your application packet:
• An original letter from the bank verifying that you or your sponsor are in “good standing” at the bank
and have at least $24,184
U.S. dollars available for the first year of your education expenses.
Note:
1. The verifying letter from the bank must be dated within the last 6 months.
2. Financial support cannot be from any source of stocks, bonds, or retirement accounts.
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 Foothill and De Anza Colleges’ admission and registration procedures
may result in my dismissal without a refund of any fees paid.
I agree to obtain and maintain health insurance coverage provided by Foothill-De Anza Community College District.
Foothill and De Anza Colleges insurance is mandatory.
I understand that if I am applying through an agent, the colleges may release information about my application or other
issues to the agent.
Name
(print as it appears on passport) Signature Date
Misrepresentation of information will be cause for dismissal.
Housing
Foothill and De Anza Colleges do not provide dormitories. For information on homestays (living with a host family),
contact International Student Placements (ISP) at info@isphomestays.com or jean@isphomestays.com.
International Student Application
If the application is submitted by an education advising agency, complete the following (Please print clearly):
Agency Name
Contact Person’s Name Telephone
Email Fax
Address (Number and Street)
(City) (Province) (Country) (Postal Code)
Yes, I have previously attended/I am currently attending an English language school
Educational History
English Prociency
Agent Information
Sharing Information About this Application
Secondary School
Indicate the secondary school/high school that you have graduated/will graduate from:
College/University
Indicate any post-secondary colleges or universities that you have previously attended, graduated from or are currently attending:
Actual or expected graduation date:
Actual or expected graduation date, and degree received (if any):
Name of School
Example: XYZ Secondary School
Name of School
Example: XYZ University
Name of School
Name of School
Name of the exam
Location - City and Country
Tokyo, Japan
Location - City and Country
Tokyo, Japan
Location - City and Country
Location - City and Country
Date exam taken
Attendance Dates
Month/Year
Attendance Dates
Month/Year
Expected start date
Attendance dates
Score
A minimum score or higher on any of the following examinations is required for direct admission: TOEFL – 61 iBT
(Foothill ETS code is 4315, De Anza ETS code is 4286); IELTS - 6.0; iTEP Academic – Level 4; Pearson PTE Academic – 45;
Cambridge -175+ on advanced or proficiency exam. STEP EIKEN (Japan) – 2A.
Examinations must have been taken within the last 2 years.
Other Options to Satisfy English Prociency Requirement:
• Attend a Partner English Language School
Complete a specied level at one of our partner English language schools (see our websites for a list of partner schools).
Yes, I am planning to attend a language school. Please send me a Conditional Letter of Admission.
• Summer Intensive ESL at Foothill or De Anza: students with a TOEFL score of 52-60 iBT; IELTS 5.0-5.9; iTEP
2.9 - 3.9; STEP EIKEN (Japan) 2,
may complete these courses for guaranteed fall enrollment.
I plan to take Summer Intensive ESL courses (check application deadlines)
Please note: For your protection, information about your application status CANNOT be shared with anyone without your approval.
If you want someone else, such as a parent or friend, to receive this information, indicate their name here:
Person’s Name (Family Name and Given/First Name) Email Telephone
-4-
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FHDA International Application F17

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Completed 11 June 2020

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