Fillable INTERNATIONALAPPLICATION 000 (Los Medanos College)

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INTERNATIONALAPPLICATION 000 (Los Medanos College)

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INTERNATIONAL STUDENT ADMISSIONS APPLICATION
Thank you for your interest in attending Los Medanos College (LMC)! LMC welcomes the diversity
international students bring to our campus. For admissions clarification, international students at LMC are those
students on F visas.
Admission requirements:
Complete the CCCApply
online application
Complete this International Student Application packet:
You may scan and email all documents to
international@losmedanos.edu or mail
TO: Los Medanos College
International Students Program
2700 E. Leland Road
Pittsburg, CA 94565
USA
Sponsor’s bank statement showing a minimum balance of $23,426.00. (Funds must be shown
in US currency)
Transcripts- To qualify for admission, students must have graduated from secondary school
(high school) or obtained a high school graduation equivalency or be at least 18 years of age by
the start of classes. Students can be admitted into LMC with scanned documents but will be
required to provide original documents issued by a school or examination board with a
signature and school stamp or seal to the mandatory orientation. If your documents are not
issued in English, we require the original document as well as the English translation completed
by your school(s) or a professional translation company.
Transfer Students- Include copy of I-20 from current US school
Demonstrated English language proficiency by exam or transcript (See page 3)
Admission Deadlines:
Fall Semester (August – December) July 1
Spring Semester (January – May) December 1
Please let us know if you have any questions regarding your application or admissions to LMC:
+1-(925)-473-7493 or international@losmedanos.edu
2
Revised
International Student Application
I wish to attend Los Medanos College in the
Fall (August) Spring (January)
Today’s Date
Last (Family) Name
First (Given) Name(s)
Date of Birth
Sex
Country of Citizenship
Country Issuing Passport
Email
MAILING INFORMATION
I wish to have my LMC I-20 mailed to me by express mail through E-Ship Global
I wish to have my LMC I-20 mailed by regular US mail
Home Country Street Address
City
Postal Code
Country
Telephone in home country
Preferred Mailing Address, if
different from home country
City
Postal Code
Country
Alternate Phone Number
How did you learn about Los Medanos College? _______________________
If other, please explain
(Choose One)
3
Revised
Demonstrate English language proficiency by one of the following:
English Proficiency
Check one of
the following
TOEFL Computer-(minimum of 157) LMC ETS Code: 4396
TOEFL Internet-(minimum of 54) LMC ETS Code: 4396
IELTS-5.0 (minimum band scores of 4.5)
IEC-Provide copy of Advanced B Certificate
Transcript(s) demonstrating successful completion of 1 year of coursework taught in
English in high school (secondary school)
EDUCATION
Educational Background
List the secondary (high school), post-secondary (college/university) and/or language school you have attended:
School/College Attended
City/Country
Date Earned
Degree/
Diploma/Certificate
Are you currently studying in the United States?
Yes No
If yes, provide information below
Name of Institution
Address
City
State
Postal Code
What is your educational goal at LMC (Check One)
A= Transfer to a four year college with Associate Degree
B= Transfer to four year college without Associate Degree
C= Earn Associate Degree in General Education
D= Earn Associate Degree in Vocational Subject
E = Earn Certificate of Achievement
4
Revised
AAT/AST Associate Degree for Transfer (Select Educational Goal: A)
Administration of Justice for Transfer - AST.ADJUS.L
History for Transfer - AAT.HIST.L
Anthropology for Transfer - AAT.ANTHR.L
Journalism for Transfer - AAT.JOURN.L
Art History for Transfer - AAT.ARTHIST.L
Kinesiology for Transfer - AAT.KINES.L
Business Administration for Transfer - AST.BSADM.L
Math for Transfer - AST.MATH.L
Early Childhood Education for Transfer - AST.CHDEV.L
Music for Transfer - AAT.MUSIC.L
Communication Studies for Transfer - AAT.COMST.L
Physics for Transfer - AST.PHYS.L
Computer Science for Transfer - AAT.COMSC.L
Psychology for Transfer - AAT.PSYCH.L
Drama: Theatre Arts for Transfer - AAT.THART.L
Sociology for Transfer - AAT.SOCIO.L
English for Transfer - AAT.ENGL.L
Studio Arts for Transfer - AAT.STUDIOART.L
AA/AS General Ed/ Liberal Arts/ Transfer Degrees (Select Educational Goal: A, B, C)
Art: Fine Arts - AA. ARTFA.L
Journalism - AA.JOURN.L
Art: Graphic Communications - AA.ARTGC.L
Liberal Arts: Arts & Humanities - AA.LAAHU.L
Biological Science - AS.BIOSC.L
Liberal Arts: Behavioral Science & Social Sciences - AA.LABSS.L
Chemistry - AS.CHEM.L
Liberal Arts: Math & Science - AA.LAMSC.L
Drama: Acting - AA.ACT.L
Music - AA.MUSIC.L
Engineering - AS.ENGIN.L
Recording Arts - AA.REART.L
AA/AS Vocational/ CTE Degrees (Select Educational Goal: A or D)
Appliance Service Technology - AS.APPLI.L
Instrumentation Technology - AS.EETIE.L
Automotive Technology - AS.AUTO.L
Fire Technology - AS.FIRE.L
Business: Accounting - AS.BUSAC.L
Management and Supervision - AS.MANSU.L
Business: Small Business Operations - AS.BUSSB.L
Nursing: Registered Nursing - AS.RNURS.L
Business: Office Administration - AS.BUSOA.L
Process Technology - AS.PTEC.L
Computer Science: Support Specialist - AS.COMSS.L
Real Estate - AS.REAL.L
Computer Science: Networking and Security - AS.COMNS.L
Travel Marketing - AS.TRAVL.L
Electrical Technology - AS.EETEC.L
Welding - AS.WELD.L
Certificate of Achievement (Select Educational Goal: E)
* Basic Law Enforcement Intensive - CA.AJBLEI.L
Networking and Security (Basic) - CA.COMNB.L
Administration of Justice - CA.ADJUS.L
Networking and Security (Advanced) - CA.COMNS.L
*
Criminal Investigations - CA.AJCIS.
*
CSU General Education - CA.CSUGE.L
* Criminal Law - CA.AJCLS.L
Electrical Technology - CA.EETEC.L
Appliance Technician I - CA.APPLE.L
Instrumentation Technology - CA.EETIE.L
Appliance Technician II - CA.APPLI.
Fire Academy - CA.FIREA.L
Graphic Communication - CA.ARTGC.L
Fire Technology - CA.FIRE.L
Automotive Technology - CA.AUTO.L
*
Intersegmental GE Transfer Curriculum - CA.IGETC.L
Business: Accounting - CA.BUSAC.L
Management and Supervision - CA.MANSU.L
Business: Office Administration - CA.BUSOA.L
Music: Commercial - Business Management - CA.MUSBM.L
Business: Retail Management - CA.BUSRM.L
Nursing: Vocational Nursing - CA.VONUR.L
Business: Small Business Operations - CA.BUSSB.L
Process Technology - CA.PTEC.L
Child Development - CA.CHDEV.L
Real Estate - CA.REAL.L
Computer Support Specialist (Basic) - CA.COMSB.L
Recording Arts - CA.REART.L
Computer Support Specialist (Advanced) - CA.COMSS.L
Travel Marketing - CA.TRAVL.L
Computer Applications Specialist - CA.COMSC.L
Welding Technology - CA.WELD.L
What is your MAJOR/PROGRAM at LMC?
Check One (1)
2016-2017
5
Revised
International Student Financial Certification
(All financial documents and information must be shown in US dollars)
The Department of Homeland Security requires you to certify that you will have the funds necessary for your
own expenses while studying at LMC, exclusive of travel expenses. Students who plan to stay in the United
States through the summer will need additional funds for the three (3) month period. Please indicate the
student’s name when submitting bank statements, especially when the statement is in the sponsor’s name.
In computing your expenses, you should keep in mind that international students (F1 status/visa) are not
allowed to work except in special circumstances, which must be authorized by the US Immigration Service. The
amount of funds required for the academic year 2017-2018 is approximately $23, 426.00 (see below) based on a
course load of 12 units (the minimum required for F1 visa students).
Listed below is an estimate of costs for students attending Los Medanos College based on 12 units/semester (the
minimum required for F-1 visa students) for the 2017-2018 academic year.
$ 7,200……. Tuition and Enrollment Fees (based on 12 units per semester)
$ 9,080……..Food and Housing
$ 1,750……..Books and Other Educational Expenses
$ 1,280……..Transportation
$ 1,116……..Health Insurance (fall 2017=$465.00; spring/summer 2018=$651)
$ 3,000……..Miscellaneous and Personal Expenses
$23,426…….Approximate Cost for the Academic Year
Certification by Student/Parent/Sponsor:
I/We guarantee to provide the total amount of funds for _______________________________ to attend Los
Medanos College. Student’s Full Name
As verification that funding is available, I/We have attached an original bank statement(s) per the admission
requirements.
Full Name of
Sponsor:
Relationship to
Student
Sponsor’s Phone
Email
Address
________________________ _______________________________________________
Date Sponsor’s Signature
________________________ _______________________________________________
Date Student’s Signature
6
Revised
HOUSING in the UNITED STATES
The college does not have on campus housing; most students arrange their own housing.
Information on the Home Stay Program can be found at www.diablovalleyhomestay.com
Do you have housing in the US?
Yes No
If yes, please provide your contact
information in the United States below
Street Address
City
State
Postal Code
US Phone Number
Email
Student’s Signature
Date
F-1 Student Conditions Agreement:
"I certify that all statements in this Application Packet are true and complete to the best of my
knowledge."
I understand that, if I am admitted to Los Medanos College:
• I must attend a MANDATORY International Student Orientation one week prior to
the beginning of my first semester.
• I must be enrolled in a minimum of 12 units/semester and complete all units with a 2.0
GPA or higher.
• I must purchase and maintain required health insurance in order to enroll and remain
enrolled (every semester) at Los Medanos College.
• I must update my address and phone number with the International Student Office
within 10 days of move/change of information.
• I understand that falsification of information within this application is cause for
immediate cancellation of registration and/or dismissal from Los Medanos College
I have read each item on this form and understand my responsibilities to Los Medanos
College.
_________________ ___________________________________________
Date Student Signature
Thank you for taking the time to complete this application process with Los Medanos College. If you have any
questions about Los Medanos College programs and/or services, contact Director of the International Students
Program Teresea Archaga at international@losmedanos.edu or call +1 (925) 473-7552.
You may also visit LMC International Students page for more information on next steps after you have been
admitted into the college.
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Completed 22 July 2020

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