Fillable Part-Time International Enrollment at Chemeketa (Chemeketa Community College)

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Part-Time International Enrollment at Chemeketa (Chemeketa Community College)

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Part-Time International Enrollment at Chemeketa
The following is a list of requirements for students planning to take Part-Time classes at Chemeketa:
All Visa Holders must submit the following documents:
1. Fill out and submit the Part-Time International Enrollment at Chemeketa Application form.
2. Submit copies of the student’s passport and visa.
3. Pre-payment for tuition will be required up front prior to registration.
a. Payment will include tuition, fees, and any other costs associated with the classes.
b. Tuition is based on $165 USD per contact hour for Intensive English classes and $291 USD
per credit hour for College level courses.
c. Fees include a non-refundable $75 International Student Service fee.
International Students on an I-20 at another school (F1 or F2 students):
4. Provide copies of transcript and/or other placement information for math and/or English
courses (test scores, transcripts, academic advisor placement recommendations). This will help
us determine if you have met the prerequisites for the courses you wish to take at Chemeketa.
a. It is the student’s responsibility to pay the transcript fee and order an offi cial copy of their
transcript when grades become available.
5. Submit a copy of the I-20 from the current school
6. Provide us the name of the course(s) you want to take at Chemeketa and whether you want to
take the class online or in person.
Sponsored students must provide a fi nancial guarantee letter with application materials prior
to registration.
Any questions? Please contact us at:
International Admissions
Chemeketa Community College
Phone: 503-399-2527
Fax: 503-365-4768
Email: internationaladmissions@chemeketa.edu
Page 1
Tuition and Fee Costs Academic Year 2020-21
The Following chart will help you in determining the cost per credit, including tuition and universal fee or the Intensive
English Contact hours costs. Other course-specific fees may apply. Be sure to check the tuition & fee column next to the
specifi c course in the schedule or online.
# Of
Credits/
Contact
Hours
Oregon (Resident)
Students
International College Level
Credit Cost
Intensive English
Contact Hours
on Universal
Fee
Total
Cost
on
1 $126 $260 $31 $291 $165
2 $252 $520 $62 $582 $330
3 $378 $780 $93 $873 $495
4 $504 $1040 $124 $1164 $660
5 $630 $1300 $155 $1455 $825
6 $756 $1560 $186 $1746 $990
7 $882 $1820 $217 $2037 $1,155
8 $1008 $2080 $248 $2328 $1,320
9 $1135 $2340 $279 $2619 $1,485
10 $1260 $2600 $310 $2910 $1,650
11 $1386 $2860 $341 $3201 $1,815
12 $1512 $3120 $372 $3492 $1,980
13 $1638 $3380 $403 $3783 $2,145
14 $1764 $3640 $434 $4074 $2,310
15 $1890 $3900 $465 $4365 $2,475
16 $2016 $4160 $496 $4656 $2,640
17 $2142 $4420 $527 $4947 $2,805
18 $2268 $4680 $558 $5238 $2,970
International students attending Chemeketa part-time will be charged a nonrefundable service fee
of $75 per term. Full time international students will be charged a $265 nonrefundable service fee.
Pre-Payment Calculation
Credit /Contact Hours Total Cost + _______________
International Service Fee $ 75 USD / $ 265 USD + _______________
Online Fee ($50 per online class) + _______________
Other Fees (Please describe / list) + _______________
Full Time New Student Fee $100 (1st Term Only) + _______________
Total Estimated Balance = ___________
Page 2
Part-Time International Enrollment Application
Term: Fall (Sep) Winter (Jan) Spring (Mar) Summer (Jun) Year_____________
Family Name____________________________________ First Name_______________________________
Male / Female (circle one) Date of Birth: Month/Day/Year________________________________
Passport #__________________________________
Visa #_____________________________________ Expiration Date ________________
Please be prepared to provide a copy of your passport, visa and I-20 (if applicable) with your application.
Home country address:
Number and Street_________________________________________________________
City_________________________________________ Province/State______________
Country____________________________________ Postal Code________________
Current USA Address:
Number and Street_________________________________________________________
City___________________________________ State_____________ Zip code_________
Phone Number__________________ Email_____________________________________
Sponsor/Family Member/Friend Contact: Name_________________________________
Phone Number__________________ Email_____________________________________
Relationship to Student_____________________________________________________
I understand that by signing this form, I agree to the terms and conditions as outlined on the fi rst page
of this application and below:
• Chemeketa Community College release of information: Chemeketa releases only very limited information regarding a
student’s:enrollment status, dates of enrollment, degree or certifi cate, program of study, athletic status, or honors awarded.
• I certify that all statements on this application are complete and true.
• I understand that submitted materials will not be returned.
Student’s Signature_________________________________________ Date_______________________
Page 3
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Course Registration Request
Term: Fall (Sep) Winter (Jan) Spring (Mar) Summer (Jun) Year_____________
Circle one of the following
Course(s) I want to take: ______________________________________________Online / In Person
_______________________________________________Online/ In Person
_______________________________________________Online/ In Person
_______________________________________________Online/ In Person
Total Number of Credits you want to register for at Chemeketa this Term:_________________
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Part-Time International Enrollment at Chemeketa (Chemeketa Community College)

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Completed 26 July 2020

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