City College of San Francisco Application Form for International Students

City College of San Francisco
International Student Application Form
(For F-1 International Student Status)
For Office Use Only
Application Received:
Date: ____________ By: _________
Method: ____ ________ _________ __
Applicant #: ____________________
Academic Program: Spring 20_____ January to May Fall 20_____ August to December
Conditional Admission: Spring 20_______ 18 Weeks - January to May 9 Weeks - March to May
Summer 20______ 8 Weeks - June to July 4 Weeks - July
Fall 20__________ 18 Weeks - August to December 9 Weeks - October to December
Intensive English Program:
Spring 20_______ 18 Weeks - January* 9 Weeks (I) - January* 9 Weeks (II) - March*
(*Sessions b eing in the month indicated) Summer 20______ 8 Weeks - June* 4 Weeks (I) - June* 4 Weeks (II) - July*
Fall 20__________ 18 Weeks - August * 9 Weeks (I) - August* 9 Weeks (II) - October*
I. Personal Information: (please print clearly)
1a. Name (as it appears on your passport)
Last (Family ): ________________________________________________
First (Given): ________________________________________________
Middle: ________________________________________________
1b. Name of your spouse (if he/she accompanied you to U.S. on F2 status)
Last (Family ): ________________________________________________
First (Given): ________________________________________________
Middle: ________________________________________________
2a. Date of Birth: _____________ / _____________ / _______________
Month Day Year
2b. Are you Under 18 years old? Yes No
(If YES, plea se submit Minor Consent Form - Download from our website)
3a. Male Female
3b. Single Married
4a. Country of Birth: _________________________________________
4b. Country of Citizenship: ____________________________________
5. E-mail Address: _____________________________________________________@___________________________________________________
6a. Complete addr ess in your home country:
Street Address |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
City |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| State/Province |___|___|___|___|___|___|___|___|___|___|___|___|___|
Postal/Zip Code |___|___|___|___|___|___|___|___|___|___| Country |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Home Country Phone Number |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
II. PERSONAL INFORMATION: (please print clearly)
6b. Complete address you wish to have your acceptance package mailed to: (please check your delivery method)
Free
Regular Air-mail or Local Mail (2 to 4 business weeks for international address) $75 DHL (2 to 4 business days, international address only)
Name of Receiver |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Delivery Street Address |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
City |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| State/Province |___|___|___|___|___|___|___|___|___|___|___|___|___|
Postal/Zip Code |___|___|___|___|___|___|___|___|___|___| Country |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Phone Number of Recei v er |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
I. PROGRAM INFORMATION: (please only select one program)
New Student Transfer Student Continuing Student Re-Enter Student CCSF ID # ______ ________________
6d. Complete local address in the U.S.: (if you are presently in the U.S.)
Street Address |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
City |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| State/Province |___|___|
Postal/Zip Code |___|___|___|___|___|___|___|___|___|___| U.S. Phone Number |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
6c. If you would like to pick up or have someone pic k up yo ur acc e ptanc e package, please provide his/her information:
Full Name: _____________________________________________________ Phone #: ____________________________________________
Relationship to Applicant: ________________________________________ E-mail: _____________________________________________
Page 2
Initial I-20 (Out of Status)
Leave of Absence
Re-Enter
Semester/Year _______ ____
Bank Statement $18,000
$50 Application Fee
Page 2/4
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City College of San Francisco Application Form for International Students PDF

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