MOORPARK COLLEGE - COMMUNITY COLLEGES OF VENTURA COUNTY
Ventura County Community College District
International Student Application For Admission
(TYPE or PRINT IN INK ONLY)
1. I plan to attend:
Moorpark College Oxnard College Ventura College
2. I am applying for the: Year, 20_____
Spring Semester Summer Session Fall Semester
3. Social Security Number:_________ - _______ - __________
(leave blank if none available)
4. Name:_____________________________________________
Family Name First Name Middle Initial
5. Date of Birth:_______________________________________
Month Day Year
6. Country of Birth:____________________________________
7. Country of Citizenship_______________________________
8. Sex: Male Female
9. Home Country Address:
__________________________________________________
Number and Street
10. City/State/Country:__________________________________
11. Postal Code:_______________________________________
12. Home Country Telephone Number :
(Include Country Code):__________________________________
13.
Personal email_____________________________________
14. Last High School Attended:
Name:_____________________________________________
Country:___________________________________________
15.High School Graduation or Date Last Attended:_____ ____
Month Year
16. Proposed Major or Course Desired:____________________
17. Last College Attended:
Name:_____________________________________________
City/State/Country:___________________________________
18. California Driver’s License Number: ___________________
19. Indicate Your Ethnicity: (Confidential)
Hispanic or Latino Not Hispanic or Latino
---------------------------------------------------------------
AC Chinese HS South American
AI Asian Indian HX Other Hispanic
AJ Japanese N American Indian,
AK Korean Alaskan Native
AL Laotian PX Other Pacific
AM Cambodian Islander
AV Vietnamese PG Guamanian
AX Other Asian PH Hawaiian
B. Black, Non-Hispanic PS Samoan
F. Filipino W. White Non-
HM Mexican, Mexican-Am, Hispanic
Chicano X Unknown
HR Central American XD Decline to State
20. Primary Language
E English
N Not English
21. Immigration Status
1 Student Visa ___F-1 ___ M-1 ___J-1
Other Visa – List Type ____________
22. Student Academic Level: (Please indicate your
education status at the beginning of the semester for which
you are applying. Mark the highest level of education
attained.)
Not a High School Graduate:
000 Not a graduate of, and no longer enrolled in high school
100 Special admit student currently enrolled in high school
200 Currently enrolled in adult school.
High School Graduate:
600 Foreign High School Diploma/Certificate of Graduation
300 U. S. High School Diploma.
400 GED or a High School Certificate of
Equivalency/Completion
500 Certificate of California High School Proficiency Exam
College Degree Received:
700 Associate Degree
800 Bachelor Degree or higher
23. Student Enrollment Status: (mark one)
1 First-time student. A student enrolled in any college
for the first time.
7 First-time transfer student. A student enrolled at this
college for the first time and who has transferred from
another college after earning credit.
5 Returning transfer student. A student who has
previously attended this college, transferred to another
college, and has now returned to this college.
4 Returning student. A student enrolled at this college
after an absence of one or more regular sessions without
interim attendance at another college.
8 Special admissions student. A student who is currently
enrolled in K-10 or a senior high school student currently
enrolled in 11-12.
24. Student Educational Goal: (Select your highest priority)
A Obtain a bachelor degree after completing an
associate degree
B Obtain a bachelor degree without completing an
associate degree
C Obtain a two year associate degree without transfer
D Obtain a two year certificate without transfer
E Earn a vocational certificate without transfer
F Discover/formulate career interests, plans, goals
G Prepare for new career (acquire job skills)
H Advance in current job/career (update job skills)
I Maintain certificate or license (e.g. nursing, real
estate)
J Educational development (intellectual, cultural)
K Improve basic skills in English, reading or math
L Complete credits for high school diploma or GED
M Undecided on goal
P
age 1 (complete reverse side)
