International Student
Admissions Application
Page 1 of 2 Rev Date 5.6.20
Applicant Identify Information
Full Name: _____________________________________________________________________________________
Last (Family Name) First (Given Name) Middle
Gender: Female Male Date of Birth (MM/DD/YYYYY):__________________________
Country & City of Birth: ______________________________________
Country of Citizenship/Passport-Issuing Country: _________________________________________________________
Passport Number: ______________________________________________________________________________
Permanent Home Country Address
Street Address (required): ________________________________________________________________________
Address Line 2: ________________________________________________________________________
City: ________________________________ State/Province/Territory: _____________________________________
Postal Code: _________________________ Country: ___________________________________________________
Current Mailing Address
(please update any address changes during the admissions process)
Street Address (required): ________________________________________________________________________
Address Line 2: ________________________________________________________________________
City: ________________________________ State/Province/Territory: _____________________________________
Postal Code: _________________________ Country: ___________________________________________________
Send I-20 documents to:
Permanent Home Country Address Current Mailing Address
I or an authorized family member/sponsor (authorization is granted through the signing of a FERPA Release
Form) will pick up my I-20 document from Nicolet College at the Rhinelander, WI campus.
Contact Information
Email Address: _____________________________________________________________________________________
Phone (please include country code): __________________________________________________________________
Academic Information
Intended Start Term and Year: Fall 20____ Spring 20____ Summer 20_____
Intended Program of Study* (Major): __________________________________________________________________
*
For information on the EMT-Paramedic (TD), Radiography (AAS), Pharmacy Technician (TD), or Pharmacy Services Management (AAS) please
email admissionsh@nicoletcollege.edu prior to submitting this form.