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International students seeking admissions based on an F-1 (Central Arizona College)

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International Student Admissions
Rev. 06/2020d
1
International students seeking admissions based on an F-1 student visa status must provide the following documentation prior
to issuance of an I-20:
Completion of the International Student Questionnaire;
Complete the Financial Support Statement;
Completion of the Admissions Application;
Submission of letter from a bank or other financial institution verifying funds for financial support;
Completion of the Test of English as a Foreign Language (TOEFL),
Scores must be sent directly from: TOEFL, PO Box 6155, Princeton, NJ08541-6155, USA;
Score requirements:
Written Test – minimum score of 450 or higher or;
Computer Test – score of 133
Submission of all official transcripts/grades from high schools and/or colleges attended;
Translation of documents into English is required, if applicable.
For more information on foreign credential evaluation services please contact one of the following agencies:
Educational Credential Evaluators (ECE) https://www.ece.org/
International Educational Research Foundation (IERF) http://www.ierf.org/
World Education Services (WES) http://www.wes.org/
Submit all information above to:
Central Arizona College / International Admissions
8470 North Overfield Road
Coolidge, AZ 85128
USA
For additional information, please contact our Admissions Office at (520) 494-5260 or international.admissions@centralaz.edu
International Student Questionnaire:
The following information is required of all International Student applicants. Please return the following completed questionnaire
with your CAC Admissions Application. Print or type all information legibly in English.
Last Name (exactly as it appears on passport)
First Name
Middle
Town
State
Zip
Country
Area of Interest
Fall Spring Summer Year:
Personal Email
International Student Admissions
Rev. 06/2020d
2
Financial Support Statement:
*Central Arizona College has no provision for scholarships for international students; therefore, students must be prepared to meet the necessary financial obligations for the entire time they
will be in the United States. This is not an application for financial assistance. It is estimated that each student will need at least $18,000 per academic year in order to meet all expenses,
exclusive of travel.
CURRENCY RESTRICTIONS:
A. Are there currently any restrictions in your home country that would limit the amount of money you are able to bring
with you to the U.S. or receive while in the U.S.? Yes No
If yes, please specify: ____________________________________________________________________
B. What is the current rate of exchange for U.S. currency in your home country? ________________________
YOUR AVAILABLE FUNDS:
A. How much can you provide from your own personal funds while attending school in the U.S.? ______________
What is the source of these funds? ____________________________________________________________
Note: If you plan to work while in the U.S. you must request permission from U.S. immigration, you may not consider this
source as income until permission is granted. Permission is difficult to obtain.
B. Have you been awarded a scholarship for your first year at Central Arizona College? Yes No
a. If yes, give the name and address of the sponsoring organization and amount:
Name: _______________________________ Amount: _______________________
Address:__________________________________
_________________________________________
C. How much money in U.S. currency do you plan to bring with you initially? ______________
SUPPORTING FUNDS (Not to include your travel costs)
A. If you expect to receive funds throughout the year, please state when the funds will be available and the amount?
Date: Amount:
a. _______________________ _______________________
b. _______________________ _______________________
c. _______________________ _______________________
B. If you plan to remain at Central Arizona College for a year or longer, what additional financial resources will you
have available?
Source: Amount:
a. _______________________ _______________________
b. _______________________ _______________________
c. _______________________ _______________________
0
International Student Admissions
Rev. 06/2020d
3
C. Family Support:
a. What is your father’s occupation? __________________________
b. How much will your family provide annually toward your education in the U.S.? ____________________
c. Family Member or Sponsor Supplying Funds:
Name: _______________________________ Relationship: _______________________
Address:______________________________ Signature: _________________________
_____________________________________ Your Currency - ____________________
_____________________________________ U.S. Currency - ____________________
TRAVEL FUNDS:
A. What is the current cost of round-trip travel to the U.S.? _____________________________________________
B. How do you plan to pay for your round-trip travel to the U.S.?
__________________________________________________________________________________________
C. If you are currently in the U.S., what financial provisions have you made for your return home?
__________________________________________________________________________________________
DEPENDENT/FINANCIAL ASSISTANCE PROVIDED BY YOU:
A. List the relationships and ages of persons who will require financial assistance from you during your academic
year or years in the U.S.
Name: Relationship: Age:
a. __________________________ ____________________ _____
b. __________________________ ____________________ _____
c. __________________________ ____________________ _____
B. Will these dependents accompany you to the U.S.? Yes No
a. If yes, state how many will accompany you and how you intend to provide support during the period of
your stay in the U.S. _________________________________________________________________
By signing below, I certify that the information given is complete to the best of my knowledge. I understand that submission of false information is grounds for denial of
admission or immediate suspension if enrolled. As a student of Central Arizona College, I agree to abide by the Student Code of Conduct of the college regarding conduct
and other obligations. In addition, I understand that Central Arizona College institutional student business conducted by electronic delivery. This includes, but not limited to
admissions, registration and billings, Form 1098-T (if applicable) and direct deposits. You may withdraw your consent of electronic delivery by writing Central Arizona
College, Attn: Accounts Receivable, 8470 N. Overfield Road, Coolidge, AZ 85128.
Student Signature: Date:
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Admissions
Form
Personal Information:
Social Security Semester of Admissions: Year 20____
Number Fall Spring Summer
*Please note that your social security number is required during your initial admissions process. After completing the admissions process, all students are assigned a Student ID
Number that can be used for all future transactions.
All students receiving Financial Aid must provide a valid Social Security Number, declare a program of interest and provide Official Transcripts from previous institutions attended.
In addition, any student that is in need of a 1098-T for Federal Tax purposes must also provide a valid Social Security Number at the time of admissions.
Legal Name: Last:_____________________________ First:__________________________ Middle Initial:_______
Previous Name (maiden):_____________________________________________________________________
Mailing Address: Street/P.O. Box:________________________________________________________ Apt.:________
City:___________________________________________ State:___________ Zip:_____________
Telephone: Home:(_____)______________ Cell: (_____)______________ Email: ______________________________
Date of Birth:________/________/________ Gender: Male Female
Month Day Year
Student Type:
Race/Ethnic Background:
CAC is a Hispanic Serving Institution. As such, CAC receives extra federal funding to support its students. In order to qualify for the funding we must maintain
at least 25% of our student body as Hispanic /Latino/Chicano. Therefore, it is VERY IMPORTANT that if you identify with one of these groups you mark the
appropriate box. This information will NOT be used in ANY other way.
Are you of Latino/Hispanic ethnicity?
YES, please specify: ¨Mexican ¨
Central American -OR- NO, if not of Latino/Hispanic ethnicity, please check all that
Cuban ¨ South American Asian ¨Native Hawaiian/Pacific Islander
Chicano ¨ Spanish Black/African American White, Non-Hispanic
American Indian/Alaskan Native; Tribe: _____________
Residency:
These questions are asked for the purpose of determining tuition and fees. State law now requires that a person who is not a citizen or legal resident of the
United States or who is without lawful immigration status is not entitled to classification as an in-state student pursuant to A.R.S. Section 15-1802 or entitled to
classification as a county resident pursuant to A.R.S. 15-1802.01. Failure to answer questions may result in being classified as out-of-state for tuition and
fees purposes. The responsibility of registering under the proper residency classification is placed upon the student. Any student who falsified his/her resi-
dency may be subject to dismissal from the college and/or criminal action. Refer to the college catalog for residency guidelines.
United States Citizen Legal Immigrant/Permanent Resident: Date of Issue ____/______
Lawful Refugee/Asylee: Date of Issue _____/_____ Country of Origin ________________
Legal Nonimmigrant:
Specify Immigration Classification _______and Date of Expiration ______/_______and Alien Registration Num./I-94 Num. ________
Do Not Qualify for any of the above
Aravaipa Maricopa San Tan Signal Peak
Superson Florence Casa Grande Center
Casa Grande Corporate Center
New/First Time Continuing *Dual Enrollment /Early College
*Minor/Under 18 (Not participating in Dual Enrollment/Early College) Non Degree Seeking
Re-entry, returning after one or more semesters Transfer Continuing Ed/Community Education *GED/HSE
Admissions Form
Continued
Residency Continued:
For in-state tuition purposes, you must reside in Arizona for one complete year to establish residency. It is the responsibility of the student to ensure that correct
residency is established at the time of admissions for tuition purposes.
Are you a legal Arizona resident? Yes No If yes, when did your residency in Arizona begin? Date: ______/______/______
If born in Arizona, please indicate birth date.
Drivers License State: _____ Drivers License Number: __________________
Are you seeking admissions under the Western Undergraduate Exchange (WUE) program? Yes No
If yes, please identify the WUE state in which you are from:
Alaska California Colorado Hawaii Idaho Montana Nevada New Mexico
North Dakota Oregon South Dakota US Pacific Territories and Freely Associated States
Utah Washington Wyoming
Students from the above participating WUE states pay no more than 150% in-state tuition. This is less than the regular out-of-state tuition costs. Students must
provide proof of WUE residency.
Education:
High School:
Did you graduate High School? Yes No
Name of High School: _________________________
Graduation/Anticipated Date: ______/______/______
Did you complete your GED? Yes No
Completion Date: ______/______/______
College:
Have you attended any other colleges? Yes No Did you earn a certificate/degree? Yes No
List all other colleges/universities that you have attended.
1. ____________________ 2. ____________________ 3. ____________________ 4. ____________________
Failure to disclose previous college(s) is a violation of the Student Code of Conduct and is grounds for denial of admission or immediate suspension if enrolled. It
is the responsibility of the student to provide Official Transcripts from all institutions indicated above for prior credit evaluation. In addition, all students receiving
Financial Aid must declare a program of study and provide Official Transcripts from previous institutions attended.
Additional Questions:
Are you a Veteran? Yes No Do you plan to use Veterans Educational Benefits? Yes No
Are you interested in On-Campus Housing (Signal Peak Campus only)? Yes No
Emergency Contact: Name: _____________________________ Relationship: _______________________ Phone Number: _____________
Area of Interest:
By signing below, I certify that the information given is complete to the best of my knowledge. I understand that submission of false information is grounds for
denial of admission or immediate suspension if enrolled. As a student of Central Arizona College, I agree to abide by the Student Code of Conduct of the college
regarding conduct and other obligations. In addition, I understand that Central Arizona College institutional student business by electronic delivery. This includes,
but not limited to admissions, registration and billings, Form 1098-T and direct deposits. You may withdraw your consent of electronic delivery by writing Central
Arizona College, Attn: Accounts Receivable, 8470 N. Overfield Road, Coolidge, AZ 85128.
Student Signature: _________________________________________________________ Date: _________________________
Associate of Arts Degree (AA)_________________ Associate of Arts Degree–Elementary Education (AAEE)
Associate of Science Degree (AS) _____________ Associate of Applied Science Degree (AAS) __________
Associate of Business Degree (ABUS) Certificate __________________________
Associate of General Studies Degree (AGS) __________
I have reviewed my area of interest with my Academic Advisor and understand that all registered classes must apply towards degree/certificate completion for
financial aid eligibility.
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International students seeking admissions based on an F-1 (Central Arizona College)

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Completed 5 September 2020

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