International Student Services and Programs
California State University, Fresno • Joyal Administration 256
5150 North Maple M/S JA56 • Fresno, California 93740-8029
UNIVERSITY
Family Name: _________________________________ Given Name: _____________________________________
I.D. Number: ___________________________________________ Birth Date: ______ / _______ / __________
Local Address: ____________________________________________________________________________________
E-mail Address: ______________________________________ Phone: ( _______ ) __________________________
Status / Type: F-1 Visa Student J-1 Visa Other: _______ Concurrent Contract
Home Institution: ____________________________________________________________________________________
Guidelines for Open University enrollment include the following (as marked):
Attend International Orientation
Purchase mandatory health insurance
Submit an application for admission for the ______________ semester by ________________
Attend American
English Institute as a full-t
ime student this semester
Make an appointment with the ISSP Immigration Specialist
Enroll in a minimum of 12 units. (of those, 3 units maximum online units). Must enroll in _____ more units.
Additional Conditions:
_________________________________________________________________________________________________
Advising Recommendations:
_________________________________________________________________________________________________
Student Signature: ____________________________________________________ Date: ________________________
The above-named student has agreed to the conditions listed above. The following registration is approved:
Subject & Course # Unit(s) Action NOTES
Signature:
_____________________________ ________
Foreign Student Advisor, ISSP Date
Present the completed, signed form to the Division of Continuing and Global Education,
Education Building Room 130, to obtain registration materials and further instructions.
Registration for Open University begins on the first day of instruction.
for approved Academic
Disqualification students
(for office use only)
______________________________ ________
Immigration Specialist (DSO), ISSP Date
Signature:
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