Fillable INTERNATIONAL APPLICATION FOR ADMISSION (North Central State College)

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INTERNATIONAL APPLICATION FOR ADMISSION (North Central State College)

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The INTERNATIONAL APPLICATION FOR ADMISSION (North Central State College) form is 2 pages long and contains:

  • 1 signature
  • 15 check-boxes
  • 104 other fields

Country of origin: US
File type: PDF

U.S.A. forms for North Central State College

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NAME (as it appears on your passport):
_______________________________________________________________________________
family/last name given/rst name middle name (if any)
PERMANENT/RESIDENTIAL ADDRESS in country of citizenship (required for immigration, no PO boxes):
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
MAILING ADDRESS ( check if same as permanent/residential address):
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
CONTACT INFORMATION:
_______________________________________________________________________________
phone number cell/mobile fax applicant email (print clearly)
PERSON TO BE NOTIFIED IN CASE OF EMERGENCY:
_______________________________________________________________________________
in United States—name phone number
_______________________________________________________________________________
in home country—name phone number
INTERNATIONAL APPLICATION FOR ADMISSION
PLEASE TYPE
or PRINT all information
completely and legibly
The year I wish to begin
_______________________
WHEN YOU HAVE COMPLETED THIS SIDE, TURN OVER AND CONTINUE.
EDUCATION Please list all institutions attended, starting with high school:
Fall (August) Spring (January)
Summer (May)
• ESL
• Accounting
• Associate of Arts
• Associate of Science
• Bioscience
• Business Administration
– Business Management
• Business Administration
– Marketing
• Computer Information Systems
• Criminal Justice
• Criminal Justice
– Law Enforcement Option
• Health Services Technologies
• Human Services
• Industrial Technology
–Manufacturing Technology
• Information Technology
–Cyber Security
• Information Technology
–Networking
• Integrated Engineering Technology
• Mechanical Engineering Technology
• Nursing - RN
• Occupational Therapy Assistant
• Physical Therapy Assistant
• Practical Nursing (LPN/Certicate)
• Pre-Mortuary Science
• Radiological Sciences
• Respiratory Care
• Science/Medical Academy
• Visual Communications
– Graphic Design
NC STATE MAJORS
(please circle)
Certication: By submitting this application I hereby certify that information stated is accurate and complete. I understand
that any misrepresentation of facts on this application could be cause for suspension from the College. Additionally, I agree
to adhere to the conduct norms of the campus community and all policies/regulations of NC State College. I understand
that NC State College does not provide health insurance.
signature ______________________________________________________date _________________
PERSONAL INFORMATION:
male single citizenship:_______________________ date of birth:_____/_____/_____
female married city and country of birth:___________________________
IF YOU ARE CURRENTLY IN THE UNITED STATES, please indicate your visa status:
F-1 or J-1 visa at (where): ___________________________________________________________
Other _______________________________________________________________________
mm dd yyyy
name of school country
began
(m/y)
end
(m/y)
qualications or exams
degree/courses
completed
click to sign
signature
click to edit
date print name sponsor signature (must match name on bank statement
relationship
(or self)
my support
(USD)
$
$
$
admissions data
* Complete this form and
email/mail with:
Proof of Financial
Support
Signature of your
sponsor on this form, or
scholarship letter
Copy of Passport(s)
Educational Credential(s)
Evidence of English
Prociency
Statement of Purpose
• Please refer to cover sheet
for detailed information.
Email to:
mmonnes@ncstatecollege.edu
or mail to:
North Central State College Admissions Oce
2441 Kenwood Circle,
Manseld, OH, USA 44906
DEPENDENTS WHO WILL ACCOMPANY YOU include copies of passports and marriage license)
family/last name rst name
birth date
(m/d/y)
sex
(m or f)
relationship country of birth citizenship
INQUIRY DATA how did you rst learn about NC State)
Advising agency: ADVISORS, PLEASE COMPLETE
NC State sta or
student:
Agency name:
Internet (website): Advisor’s name:
Publication or other: Advisor’s email:
ENGLISH PROFICIENCY SCORES
_______________________________________________________________________________
TOEFL score date list other tests taken
FINANCIAL CERTIFICATION
North Central State College is required by the United States Citizenship and Immigration Service (USCIS) to verify that nancial support is
available for the rst academic year (9 months) of educational and living expenses. You will also need to provide similar nancial information
and documentation at your interview for a student visa.
Estimated cost for a traditional program for August 2017 to May 2018 is $19,500 USD.
[Add $4,200 USD for spouse and $2,200 USD for each dependent child (age 0-18)]
Estimated cost if taking English as a Second Language (ESL) courses is $25,500 USD.
Include a bank statement (s) or certicate of balance for each source of support (not be more than 6 months old). Total amount of support
must meet or exceed total costs. A separate letter of support or sponsorship may be submitted in place of a signature on this form.
Please include applicant’s name and birth date on all correspondence.
I certify that the amount of money indicated above is available for the rst academic year of study in the United
States, and that each subsequent year this amount of money will be available.
$
MY TOTAL
SUPPORT
nancial
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INTERNATIONAL APPLICATION FOR ADMISSION (North Central State College)

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Completed 26 July 2020

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