Fillable International Admissions Application (Eastern Oregon State College)

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International Admissions Application (Eastern Oregon State College)

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Eastern Oregon University
Admissions Application for International and Compact of Free Association (COFA) Students
Eastern Oregon University is committed to providing
equal education opportunities to all qualified students
without regard to race, color, sex, national origin, age
religion, marital status, disability, veteran status, sexual
orientation, gender identity or gender expression.
Direct related inquiries to the Armative Action Oce,
Human Resources, One University Blvd., La Grande, OR
97850; phone 541-962-3548.
One University Blvd.
La Grande, OR 97850
541-962-3393 or 800-452-8639
FAX: 541-663-9825
international@eou.edu
www.eou.edu/international
Application for International Admission
Application deadlines: Fall term: September 1 Winter term: December 1 Spring term: March 1 Summer term: June 1
For additional information about becoming admitted to Eastern Oregon University, go to
eou.edu/admissions/international-requirements. Admission is for degree seeking students. If you were previously admitted and have
not earned a degree, use the Returning Student Application at eou.edu/admissions/apply. For international admissions procedures
go to eou.edu/international and select Info sheet/Checklist. A $90 application fee (non-refundable) is required.
Year and term you plan to begin: Year _____ Summer _____
New/freshman _____
Fall _____ Winter _____ Spring _____
Transfer _____ Post-baccalaureate _____Student type:
Primary location: La Grande campus _____ Regional center (COFA only) _____ Online _____
__ __ __ __ __ __ __ __ __ (For internal use only)
Personal information
Social Security Number (if applicable)
*See enclosed disclosure and consent statement.
Legal name exactly as it appears on your passport.
Legal name ___________________________________________________________________________________________________
Last /surname (Required) First/given Middle
Other name(s) that may appear on your academic records:
_____________________________________________________________________________________________________________
Last/surname First/given Middle
_____________________________________________________________________________________________________________
Current mailing address (Required) City Province/State Country Zip
_____________________________________________________________________________________________________________
Permanent address (Required) City Province/State Country Zip
_____________________________________________________________________________________________________________
Home phone (Required) E-mail address
___________________________________________________________
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Check here to receive crucial information from EOU by text.
Cell phone
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Check here to receive EOU Emergency Alert System texts.
Emergency contact information: Please provide parent(s), legal guardian, relative or friend that can be reached in case of emergency.
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Parent(s)
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Legal guardian
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Other (specify) _________________________
_____________________________________________________________________________________________________________
Last First Middle
_____________________________________________________________________________________________________________
Mailing address City Province/State Country Zip
_____________________________________________________________________________________________________________
Primary phone Cell ___ home ___ E-mail address
Your gender** Male ___ Female ___ Your date of birth ______ / ______ / ______ Month/Day/Year
Ethnic/racial identification: Please indicate your ethnic identity by selecting one of the following:
(Note: In compliance with federal reporting requirements, EOU must seek to identify the ethnic background of applicants for admission.
You are encouraged to supply this information, but may decline without prejudicing your application in any way.
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Hispanic
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Non-Hispanic
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White, European American
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Asian American (specify ethnic group) __________________________
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Pacific Islander (specify ethnic group) __________________________
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Hispanic American (specify ethnic group) _______________________
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American Indian (specify tribal affiliation)
____________________________________________________________
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Alaska Native
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Black, African American
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Middle Eastern (specify ethnic group) __________________________
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North African (specify ethnic group) __________________________
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If none of the above is appropriate for you, please write in the ethnic/
racial identification you use ____________________________________
Academic information
What is your degree objective: Bachelor _____ Associate _____ Certificate _____
Primary major: __________________________________________________________________ Undecided _____
What is your career objective: ______________________________________________________ Undecided _____
Secondary/high school information: Please complete even if you will be entering as a transfer or graduate.
_____________________________________________________________________________________________________________
Name secof ondary/high school City/Country
Date of graduation or date you expect to graduate from secondary/high school: ________________
Colleges/universities attended: List below every college and/or university you have attended or are currently attending whether or not
credits were earned. Omitting a prior college or university from this list may result in denial of admission or disciplinary action. Send
ocial transcripts directly to the Oce of Admissions at Eastern Oregon University. Applicants with foreign transcripts see enclosed
Transfer Admission Policy and Procedures. For additional colleges, please attach a separate sheet.
Enrolled
From To
School Name City/State/Country Mo Yr Mo Yr
Degree received and
credits completed
Examination information: Identify the test you have taken or plan to take and the dates you did take or will take them. Please self
report your scores or attach an ocial copy of your results here.
TOEFL _____ Date __________ Score _____ IELTS _____ Date __________ Score _____
Canadian students only/COFA optional:
SAT Reasoning _____ TSWE _____
SAT I _____
SAT II _____
V _____ M _____
V _____ M _____
Test _____ Score ____ Test _____ Score _____ Test _____ Score _____
Citizenship
Country of citizenship: _______________________________________________
Country of birth: ______________________________________
Native language: ___________________________________________________
For international students only
Current U.S. visa you now hold:
Student (F-1) _____ Exchange Visitor (J-1) _____ Other _____ None _____
If you hold a U.S. visa issued by SEVIS (Student and Exchange Visitor Information System):
Are you entered in SEVIS?
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Yes
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No If yes, what is your SEVIS number? N___________________________________________
Are you currently in status?
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Yes
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No
Will you leave the U.S. for 5 months or more between studies?
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Yes
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No
If your spouse and/or children will accompany you to EOU, provide on a separate sheet their name, date of birth, country of
citizenship, country of permanent residency, city and country of birth and relationship to you. Please provide a copy of each accom-
panying you their identification pages in their passports.
**EOU Legacy: Did anyone in your immediate family attend EOU?
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Yes
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No
_____________________________________________________________________________________________________________
Name Relationship Year Degree earned
Did your parent(s) complete a 4-year college education?
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Yes
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No
**Activities you plan to be involved in at EOU:
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Music performance
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Theatre
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Student newspaper
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Student government
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Outdoor programs
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Varsity athletics (specify sport) _____________________
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Other ________________________________
**How did you learn about EOU? ___________________________________________________________________________________
Signature required
I certify the information on this application is correct and complete. I understand that withholding records of academic work or giving
false information is grounds for dismissal or denial of admission. I also understand that, whether or not I enroll, this application and all
other submitted documents will not be returned to me. (Please sign in ink. This application is valid for one year prior to matriculation.)
Signature: _____________________________________________________________________________________________________
Applicant’s signature Date
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My $90 application fee is attached (international students only)
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My $50 application fee is attached (COFA students only)
Eastern Oregon University is committed to providing equal education opportunities to all qualified students without regard to race,
color, sex, national origin, age, religion, marital status, disability, veteran status, sexual orientation, gender identity or gender expres-
sion. Direct related inquiries to the Armative Action Oce, One University Blvd., La Grande, OR 97850; telephone 541-962-3548.
**This information will not be used for making admissions decisions. However, you are encouraged to provide this information for data collection, application processing and research purposes.
* Social Security Number Disclosure and Consent Statement
As an eligible educational institution, EOU must receive your correct social security number (SSN) to file certain returns with the IRS and to furnish a statement to you. The returns EOU must file contain infor-
mation about qualified tuition and related expenses. Privacy Act Notice—Section 6109 of the Internal Revenue Code requires you to give your correct SSN to persons who must file information returns with the
IRS to report certain information. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. For more information please refer to IRS code 6050S. You will be issued
a student ID number for your academic record at Eastern.
12/02/2016
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International Admissions Application (Eastern Oregon State College)

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Completed 20 August 2020

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