INTERNATIONAL STUDENT APPLICATION

 

_________________________________________________________________

(Last Name)                              (First Name)                            (Middle Name)

Male____________  Female___________________ 

 

            Telephone no. ________________Email address__________________________

           

Home country address:  ______________________________________________

                                                   ______________________________________________                        

            U.S. mailing address (if any):  _________________________________________

                                                   ______________________________________________

           

Date of Birth­­­­­­­­­­­­________Country of birth________Country of citizenship________

 

            What type of United States visa do you hold, if any:________________________

 

           

Father’s name_____________________________   Father living?____________

 

            Mother’s name____________________________   Mother living? ___________

 

            Name of legal guardian, if not your parent:  ______________________________

 

            Place of legal guardian’s residence:  ____________________________________

           

EDUCATIONAL RECORD:

            Have you ever attended any other college/school in the United States? 

Yes ____  No____  If so, which school__________________________________

 

Are you transferring from another college/school in the United States?  Yes     No

                                                                             

If you are transferring, name of school you are transferring from?_____________

______________________  Address:  __________________________________

_________________________________________________________________

           

When were you last enrolled at the above college/school? Semester/Year_______

           

For which semester are you applying for admission to Los Angeles Harbor College?    Fall  ____________________ Spring __________________________

           

            What will your major be? ____________________________________________

 

            What are your plans after completion of your education in the United States?

            _________________________________________________________________

 

            Have you taken the TOEFL?  Yes ____  No  ____  If so, when?  _____________

 

            What was your score?___________

 

            List all secondary schools, colleges, universities, or technical schools attended:

            Name of school                 Location                 Entered   Withdrew  Years attended                  __________________________________________________________________

            __________________________________________________________________

 

FINANCIAL STATEMENT:

            How much money will you receive each month while you are studying in United

            States?  (U.S.dollars) $___________  From what source?  __________________

 (Note: The amount you receive must be equal to at least $14,282 in your first year)

           

            How long will you have support?  ______________________________________

 

            Can you draw on these funds regularly?  _________________________________

           

            Is there any other source of support?   Yes  ________    No  _________________

 

            Name of U. S. sponsor (if any) _______________________ Phone # __________

 

            How much support will you get from U. S. sponsor?  _______________________

 

            Will  you get room & board? _________________________________________

 

            Please check off the financial documents you have enclosed:*

            Bank Statement_____Letter from bank_____Income tax returns_____Other_____

* Note: You will need to bring original financial statements to the US Embassy for your interview.

 

In signing this document, I attest to the fact the above statements are accurate and complete to the best of my knowledge.

          

 

 

 

 

Signature:____________________________  Date:_______________________