International Student Application Checklist

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1 International Student Application Checklist We are pleased that you are considering Clark College. This checklist and application should give you the basic information you need for admission to Clark College. We look forward to welcoming you to our campus. Please contact the Office of International Programs for assistance. Please submit the following: Clark College International Student Application $80.00 USD non-refundable application and courier fee (if outside the U.S.) or $50.00 USD non-refundable application fee (if inside the U.S.) Checks or money orders must be drawn on U.S. bank and made payable to Clark College. Fees may be paid by credit card. (See page 3 of International Student Application) Copy of Passport photo page Proof of financial support for one year of study Transcripts from current or most recent school attended Transfer Students: If you are a student transferring to Clark College from another school in the U.S., please submit the above documents and the following: Copy of visa and current I-20 Transfer release form (Submit after admission to Clark College.) Mail, fax or your application materials to: Clark College Office of International Programs, GHL Fort Vancouver Way Vancouver, WA USA Phone: Fax: Website: e-brochure: Facebook:

2 International Student Application Office of International Programs College Use Only ID SECTION 1: PERSONAL INFORMATION (Please Print Clearly) All appropriate areas must be completed Family Name (as it appears on your passport) Country of Birth Country of Citizenship First Name (as it appears on your passport) Date of Birth (mm/dd/yyyy) r Male r Female What quarter and year would you like to begin? Year r Fall r Winter r Spring r Summer Dependents (spouse and children): Please list all dependents you plan to bring with you (List full name, gender, date of birth, country of birth, and country of citizenship for each): Name (Family, First) Gender (M/F) Date of Birth (mm/dd/yyyy) Country of Birth Country of Citizenship Relationship (Spouse/Child) Name (Family, First) Gender (M/F) Date of Birth (mm/dd/yyyy) Country of Birth Country of Citizenship Relationship (Spouse/Child) If you have more than 2 dependents, please list the information on a separate page and attach it to this document. Permanent Address in home country (required): U.S. Address (if currently living in the U.S.): Address with apartment # Address with apartment # City Province City State Postal Code Country Postal Code Country Telephone (country code/city code/number) Fax (country code/city code/number) Address Telephone (country code/city code/number) Fax (country code/city code/number) Address Emergency Contact Information (either in the U.S. or abroad): Agency / Advising Center Information: Name Agency Name Phone Number Address Agency Contact Person Address Relationship Phone 2

3 SECTION 2: VISA INFORMATION (Please read the section below and answer all questions.) Are you currently in the U.S.? r Yes r No If yes, what is your visa status? r F-1 r B-1/B-2 Other (specify) Are you transferring from a school in the U.S.? r Yes r No (if yes, you must submit a copy of your current passport, visa, I-20. A transfer release form will be sent to you after admission.) If yes, School Name: City/State: Are you in status? r Yes r No SECTION 3: PROGRAM INFORMATION Which program would you like to study? r Intensive English Language Program (IELP) r College/University Transfer Major (required) r Other SECTION 4: EDUCATION Are you a High School graduate? r Yes r No If yes, month and year of graduation: (mm/yyyy) Name of High School Please list all previous language school, colleges, and universities attended*: Name of school (current or most recent) Name of school Name of school *You must provide a transcript from your current or most recent school, college or university attended. SECTION 5: CONDITIONAL ADMISSION (NOT REQUIRED) You may request conditional admission to one of Clark College s university partners. To qualify for conditional admission, you must be admissible to Clark College and meet the minimum requirements for admission to the selected university. To learn more about our university partners, see this website: To receive a conditional letter of admission with your admission letter from Clark College, check the box below and add the name of the university. r (name of the selected partner university) SECTION 6: HOW DID YOU LEARN ABOUT CLARK COLLEGE? r Website r Embassy r Agency Name r Friend or relative name r Language School r Education Fair r Other 3

4 SECTION 7: FINANCIAL INFORMATION Items Tuition Annual Cost (3 academic quarters = 9 months) $8,840 + Fees (12 credits per quarter) Health Insurance $1,098 Books & Supplies $1, Costs are estimates and subject to change. Actual expenses may vary. 2. Add $3,600 for each depedent (spouse or child). 3. Add $1,100 for IELP (based on 18 required credits). 4. Amount on bank statement must equal the Financial Statement Requirement. Housing & Meals $7,080 Homestay Option Personal Expenses $1,382 Financial Statement Requirement $19,400 (3 quarters = 9 months) TOTAL FUNDS AVAILABLE International students are required to submit proof of financial support. Financial support documents must be less than 6 months old. If you have personal funds or family funds, you must submit an official bank statement or bank letter showing at least the Financial Statement Requirement amount listed in the chart above. If you have a scholarship, or government sponsor, you must submit a copy of your financial guarantee or award letter. If you have a U.S. sponsor, you must submit an Affidavit of Support Form I-134 available here: Check (a) the box below and write the amount of your financial support (required). r Personal $ r Family $ r U.S. Sponsor $ r Scholarship/Government Sponsor $ r Other (specify) If you have a sponsor, complete the information below Name of financial sponsor Relationship to applicant Signature of Sponsor (required) SECTION 8: CREDIT CARD PAYMENT: FOR CREDIT CARD PAYMENT Credit Card Number: Amount Charged: r $80 USD for Application & Courier Fee (if outside the US) or r $50 USD for Application Fee (if within the US) Credit Card Type (i.e. Visa, MasterCard, Discover) Card Expiration Date Cardholder s Name (please print) Authorizing Signature 4

5 SECTION 9: APPLICANT SIGNATURE (All applicants must sign the application form below) r I certify that funds are available to pay all tuition, fees and living expenses during my period of stay at Clark College. I will notify Clark College of any changes in my financial situation. r I certify that I will be covered by health insurance while I am an international student in the U.S. I will purchase health insurance through Clark College each term unless I prove coverage from an approved government sponsor. r I certify the information I have provided is accurate and complete. Student name (print) Student/applicant signature Date (mm/dd/yyyy) For additional information: Clark College Office of International Programs, GHL Fort Vancouver Way Vancouver, WA USA Phone: Fax: Website: e-brochure: Facebook: Rev 9/10/2014 Clark College does not discriminate on the basis of race, color, national origin, sex, disability, age, religion, sexual orientation, gender identity, gender expression, political affiliation, creed, disabled veteran status, marital status, honorably discharged veteran or Vietnam-era veteran status in its programs and activities. 5

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