Fillable International Application (Indian Hills Community College)

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International Application (Indian Hills Community College)

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The International Application (Indian Hills Community College) form is 3 pages long and contains:

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  • 30 check-boxes
  • 43 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Indian Hills Community College

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New Students Must Submit:
Application for Admissions
Financial letter from bank (must provide an ofcial letter written in English showing
sufcient funds in U.S. dollars for one year of study at Indian Hills Community College)
Copy of your passport
Ofcial nal high school transcript (must be translated into English)
F-1 Transfer Students Must Submit:
Application for Admissions
An International Student Transfer-In Form; completed and signed by the U.S. institution you
are currently attending, click here to nd the form International Student Transfer-In Form
Copies of your current Visa, Passport, and I-20
Ofcial transcript from the institition you are currently attending
Financial letter from bank (must provide an ofcial letter written in English showing
sufcient funds in U.S. dollars for one year of study at Indian Hills Community College)
All Students Must:
Report in person to orientation for new international students
Present originals of these documents at orientation: Passport, Visa, and I-20
Enroll full time and attend IHCC for a minimum of two 12-week terms
Be a high school graduate
Complete the COMPASS test at Indian Hills Community College
OFFICIAL ENGLISH TRANSLATIONS ARE REQUIRED FOR ALL DOCUMENTS
Indian Hills Community College
International Affairs Office 525
Grandview Ave.
Ottumwa, IA 52501
internationals@indianhills.edu
-1-
PERSONAL CONTACT INFORMATION (PLEASE PRINT):
Last Name (family name, as it appears on passport):
First Name (given name, as it appears on passport):
Middle Name(s), if any:
Current Mailing Address (IHCC’s I-20 will be mailed to this address unless you indicate otherwise):
City: State/Province:
Country: Zip/Postal Code:
Country of Birth: Country of Citizenship:
Date of Birth: Month: Day: Year:
Gender: E-Mail Address:
Phone:
Country code City/area code Number
Same as Current Mailing Address
Non-US Address:
City: State/Province:
Country: Zip/Postal Code:
GENERAL INFORMATION:
Which campus do you plan to attend? Ottumwa Centerville
What term do you plan to start at IHCC? (Each term is 12 weeks in length. Please check appropriate box).
YEAR
Fall (August) Winter (November) Spring (February) Summer (May)
Your chosen Program of Study:
Arts & Sciences (General Education)
ESL (English as a Second Language)
Other (Please check our courses and programs at www.indianhills.edu/courses):
Housing/ Dorms: If interested in on-campus housing, please apply at the following links.
Ottumwa Campus: www.indianhills.edu/housingottumwa
Centerville Campus: www.indianhills.edu/housingcenterville
Is English your primary language? Yes No
If no, please state your primary language:
If no, do you speak uent English? Yes No
Are you a high school graduate? Yes No
If not, when will you graduate? Month: Year:
Have you attended school in the U.S. before? Yes No
If yes, where? Date(s) attended:
The TOEFL is NOT required to enroll at IHCC but if you have taken it, please provide your score(s):
-2-
FINANCIAL INFORMATION:
International students (F-1 visa) applying for admission to Indian Hills Community College must certify that they will have
adequate funds to pay for all educational and living costs. Please submit the ofcial supporting documents with this
nancial statement to Indian Hills Community College.
STUDENTS TRANSFERRING FROM ANOTHER U.S. INSTITUTIONS: You will need to submit all ofcial documents
including the ofcial letter from the bank showing sufcient funds for one year of study at Indian Hills Community College.
Additional documents may be requested.
Indian Hills Community College estimates a student’s average cost per academic year (3 terms = 9 months):
Tuition
Room and Board
Book and Supplies
Health Insurance
TOTAL
$7,200.00
$5,520.00*
$800.00
$1632.00
$15,152.00**
*For students who plan to apply/attend the Centerville Campus, please add $450 to the amount above (for a total of $15,602) due to meal plan options.
** All costs are estimated and are based on a 9-month academic year. Tuition is charged on a per credit hour basis, and tuition rates are determined by
the IHCC Board of Trustees each summer.
How will you pay for the total amount listed above?
Personal/Family Funds
Sponsor within the U.S.
Scholarship:
Other (please explain):
An ofcial letter written in English must be provided showing sufcient funds in U.S. dollars for the total amount listed above.
Note:
I understand that Indian Hills Community College does not guarantee on-campus employment. I understand that under
immigration law I cannot work off-campus and I do not plan to work in the U.S. to pay for my educational and/or living
costs.
RELEASE AND WAIVER SIGNATURES
The undersigned hereby gives to Indian Hills Community College, its ofcers, employees, agents, and host families full authority and permission to
take whatever action they feel is reasonably warranted under the circumstances, and to act as agent of the undersigned student and parent/guardian,
regarding the named student’s health and safety. This authority and permission includes, but is not necessarily limited to, the following: Rendering or
ordering medical treatment; the giving of medication; and any examinations, X-rays, anesthetic, medical or surgical diagnosis or treatment or hospital
care, if and as deemed necessary.
The undersigned understands that a reasonable attempt will be made to contact the undersigned parent/guardian before any action is taken. The
undersigned agrees to be nancially responsible for all medical attention so authorized or ordered during the student’s attendance at Indian Hills
Community College. The undersigned represents that the named student has no medical restriction that limits his/her full participation in the programs
and activities of Indian Hills Community College, except as disclosed in any writing attached to this document.
Permission is given for the student to participate in all activities offered at Indian Hills Community College, except as restricted in any attached writing.
To the fullest extent permitted by law, the undersigned hereby releases Indian Hills Community College, its ofcers, employees, agents, and host
families from all liability, and waive and release all claims, related to or arising from such decisions or actions as may be taken under the authority of this
document.
By signing this, the undersigned agrees that if they enroll in their initial (rst) term at Indian Hills Community College, and then completely withdraws
or transfers to another institution before completing two 12-week terms of coursework, they will be charged a $100 administrative fee. Indian Hills
Community College will also bill the student all costs related to shipping the I-20 document to his/her home country.
Student’s Name (print): Date:
Student’s Signature:
“I verify that to the best of my knowledge all of the statements on this form are true.”
I accept I decline
-3-
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International Application (Indian Hills Community College)

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Completed 19 July 2020

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