ADMISSION APPLICATION

Please submit your application to: International Programs North Seattle Community College 9600 College Way N. Seattle, WA 98103 USA Tel: 1-206-527-3672 * Fax: 1-206-527-3794 international@sccd.ctc.edu * http://isp.northseattle.edu/ TO APPLY, PLEASE SEND: A completed application and a $50 U.S. application fee (nonrefundable) A current bank statement of $17,200 U.S. (minimum) A copy of your passport photo page STUDENT INFORMATION

New Student Transfer Student Concurrent Students Returning to NSCC Student number ______________________

(Please print or type)

Send my I-20 to this address

Surname or Family Name (as it appears on passport)

First or Given Name

Middle Name

Permanent address in home country

City

State/Province

Zip/Postal Code

Country

Telephone number (area code + number)

Fax

Email

Date of Birth (month/day/year)

Gender Male Female

Marital Status Married Single

Country of Birth

Country of Citizenship

ADDITIONAL CONTACT INFORMATION U.S. or agent name (if applicable)

Send my I-20 to this address Address

City

State/Province

Zip/Postal Code

Country

Telephone number

Fax

Email

PROGRAM INFORMATION What is your intended program of study? (Mark all that apply) Major: ___________________________ Intensive English (ESL) High School conversion/Associate Degree/University Transfer Associate Degree College/University Transfer Applying for: Summer 2010 (June 28-Aug 20) Fall 2010 (Sept 27-Dec 16) Winter 2011 (Jan 4-Mar 23) Spring 2011 (Apr 4-June 17) Did you graduate from high school? No Yes, name of High School _____________________________________

University Conditional Admission (check only one) NSCC has conditional admission to partner universities for students in the college transfer program. If you are interested in receiving conditional acceptance, check one of the universities. (http://isp.northseattle.edu/university_transfer.html) Eastern Washington University San Francisco State University Johns Hopkins University, Carey Business School University of Oregon Purdue University (IUPUI) Eastern Connecticut State University Montana State University

Thank you for choosing NSCC We look forward to welcoming you to our campus

STUDENT NAME: (Print): ________________________________________________________ VISA INFORMATION Are you currently in the U.S.A.? No Yes Visa type: _______________________ Are you attending school in the U.S.? No Yes Name of school __________________________ (If you are attending school in the U.S., you need to submit a copy of your I-20, I-94 and visa) REFERRAL/AGENT INFORMATION How did you hear about North Seattle Community College? Agency (Name) _______________________________ Language School (Name) ________________________ Friend or Relative (Name) _______________________ Education fair (Name/Year) ______________________ Embassy (location) _____________________________ Website ______________________________________ Advertisement (magazine) ______________________ Teacher or Advisor (name)_ ______________________ NSCC student (name) ________________________ Other _____________________________________ PAYMENT $50 U.S. non-refundable application fee is required to process your application. Card Type Visa MasterCard Discover American Express Card number: _________________________________ Expiration Date: month _______ year_______ CVV Number (last 3 digits on the back of card) ______ HOUSING I do not need help with housing Please advise me of my options Homestay Apartment Room

HEALTH INSURANCE Students will need to purchase health insurance that is valid in the United States if they do not have insurance from their home country. FINANCIAL RESPONSIBILITY All international applicants are required to show proof of financial support to live and study in the United States. This includes sufficient funds available to pay for all necessary expenses and tuition for the time you are studying in the U.S. The sources of these funds will continue through the duration of your study at North Seattle Community College. This section must be completed and signed before admission. Please attach a bank statement (not more than 6 months old) with this application. Please NSCC's website for current tuition fees: (http://isp.northseattle.edu/costs_dates.html). I understand that I am not eligible to receive financial aid, such as grants or loans. I also understand the tuition and fees refund policies as outlined on the website. I will pay my tuition and living expenses with: (check all that apply) Personal Funds Family Funds Government sponsorship from home country Company sponsorship Sponsor within the U.S. (additional documents required) Other _________________________________ SIGNATURE I verify that I understand the above questions and that the information I have provided is complete and true. I authorize NSCC to release my information from my records which is needed by US immigration officials pursuant to 8 CFR 214.3(g) to determine my nonimmigrant status. Signature: ______________________________________________ Date: __________________________________

Your application is not complete until you have submitted all the required documents! *Passport photo page (REQUIRED) *Bank/Financial statement (REQUIRED) *If applying for high school completion or under 18 years old, submit high school transcript *I-20, I-94 and visa (if transferring)