AANMELDING International student - Green River Community College KILROY education helpt je met de aanmelding aan Green River Community College. Onze studieadviseurs informeren je over opleidingen, toelatingseisen, collegegelden, eventuele studiebeurzen, huisvesting en visa. We maken graag een afspraak met je voor een persoonlijk advies op het kantoor van KILROY in Utrecht en staan tijdens het gehele aanmeldproces klaar voor al je vragen. Neem contact met ons op om een afspraak in te plannen. Naast studieadvies en begeleiding kan KILROY je ook helpen met vliegtickets en een reisverzekering speciaal voor studenten die langer in het buitenland verblijven. Weet je al wat je wilt studeren? Vul dan hieronder direct het aanmeldingsformulier in. Stuur het aanmeldingsformulier en de bijbehorende documenten per post of e-mail naar KILROY education. Wij controleren of alle gegevens juist zijn ingevuld en de juiste documenten zijn meegestuurd. Daarnaast zijn wij bevoegd jouw diploma’s te certificeren en kunnen wij de aanmelding snel afhandelen door alle documenten per e-mail aan Green River Community College te versturen. Zorg ervoor dat je alle velden van het aanmeldingsformulier invult. Lees de onderstaande tips voordat je het formulier invult: - Personal, Contact & Financial information: Vul de gevraagde persoonlijke gegevens in. - Education: Schrijf hier je huidige en voorgaande opleidingen vanaf de middelbare school op. Als internationale student moet je in de meeste gevallen een Engelse taaltest afleggen. De testen die je kunt doen zijn de TOEFL-test of de IELTS-test. Geef hier tevens aan wanneer, wat en hoelang je wilt studeren. Neem contact met ons op voor meer informatie. - Housing: Vul de gevraagde gegevens betreffende huisvesting in. - Vergeet niet te ondertekenen! -
Stuur het aanmeldingsformulier en de bijbehorende documenten naar KILROY education
Checklist aanmelding bachelor Diploma van de middelbare school in het NEDERLANDS en ENGELS. Indien nodig kan KILROY je diploma en cijferlijst vertalen naar het Engels. Kopie van je paspoort Indien nodig: de score van je taaltest (bijv. IELTS/TOEFL). Weet je niet of je een taaltest Engels moet doen? Neem contact met ons op voor meer informatie.
Vergeet niet de gecertificeerde kopieën te ondertekenen en mee te sturen!
Stuur het aanmeldingsformulier en de documenten naar: KILROY education Nobelstraat 117 3512 EM UTRECHT
[email protected]
Green River Community College International Student Application For Green River office use only: 84492- ____________________
Received: _____________
Please submit your application to:
Application Check List
International Programs
❏ Applicant must be at least 16 years of age by program start date
Green River Community College
❏ Completed application
12401 SE 320th Street
❏ Financial statement – Official bank letterhead in English showing enough funds for one year of study at Green River (see website for current amount)
Auburn, WA 98092-3622 U.S.A. Fax: 1 - (253) 333-4940
❏ $50 non-refundable application fee
E-mail:
[email protected] Apply online: greenriver.edu/international
❏ Housing choice
Phone: 1 - (253) 288-3300
❏ $300 Housing placement
E-Brochure: mi-america.com/grcc/welcome/index.php
❏ Copy of passport
IP Blog: insidegreenriver.com facebook.com/groups/64565165785/#!/GRCC.IP youtube.com/user/greenriverintlprgms
❏ Transcript from last school attended, sealed by school (highly recommended) ❏ For transfer students only: Transfer-In Form (available by request or on website)
twitter.com/grccip
Personal Information ❏ New student
❏ Transfer student
Date of birth: __________________________ / /
❏ Returning Green River student
month
day
year
❏ Male
❏ Female
Last name (family, as it appears on passport): __________________________________________________________________ First name (given, as it appears on passport): ___________________________________________________________________ Middle name(s), if any: ______________________________________ Country of birth: ___________________________________________ Country of citizenship: ______________________________________ Native language: ____________________________
English Ability: ❏ Fluent
Visa Type:
❏ J-1
❏ F-1 Student
Dependents arriving with you:
❏ M-1 Student ❏ Spouse
❏ Average ❏ Poor
❏ Other
❏ Children
Do you have any medical conditions or allergies? ❏ No
❏ Yes, describe: __________________________________________
Do you require any special physical or learning assistance? ❏ No
❏ Yes, describe: ___________________________________
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IP1307App1314
Contact Information Home country/current address:
Emergency contact name and address:
_______________________________________________________
_______________________________________________
_______________________________________________________
_______________________________________________
_______________________________________________________
_______________________________________________
Phone: __________________________________________________
Phone: _________________________________________
E-mail: __________________________________________________
E-mail: _________________________________________
Where would you like your I-20 sent? ❏ Home country address ❏ Current address ❏ Agency/Advising Center (provide address below) ❏ Other (provide address below) Agency/Advising Center or other mailing address (if applicable) Agency Name: ______________________________________ Agency Contact Person: _______________________________ Address: _______________________________________________________________________________________________ ______________________________________________________________________________________________ Phone: ________________________________________________________________________________________________ Fax: ___________________________________________________ E-mail:________________________________________ Financial Information How will you pay for your tuition and living expenses? ❏ Personal funds
❏ Family funds
❏ Government sponsorship from home country
❏ Company sponsorship from home country
❏ Sponsor within the U.S. (I-134 required)
❏ Other ____________________
❏ I am including the following payments with this application (check all that apply): ❏ $50 Application fee is enclosed (non-refundable) ❏ $300 Housing placement fee is enclosed (refundable upon request up to 2 weeks before move-in day) ❏ Payment by credit card: ❏ Visa ❏ MasterCard
Card Number: ____________________________________________________ Expiration Date: ________________
Name as it appears on the card:________________________________________________________________________________ Total charge amount (select one only) ❏ $50 (application fee only)
❏ $300 (Housing placement fee only)
❏ $350 (Both application and housing placement fee)
Signature of cardholder:___________________________________________________________________________________ ❏ Payment by bank wire transfer to:
U.S. Bank, 401-15th Street NE, Auburn, WA 98071
ABA No. 125000105
Student Name (must be included with wire information)
Green River Student ID Number (if known)
Green River Community College
International Account No. 153504623387
SWIFT code: USBKUS44IMT
Important! Send an e-mail to
[email protected] with student name, date of birth, amount of money and date wired.
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Education Are you a high school graduate? ❏ Yes
❏ No
If yes, month and year of graduation: __________________________
Name of school you are currently attending or school last attended:____________________________________________________ TOEFL score: _____________ Date: ________________
IELTS score: ______________ Date: ________________
When would you like to start at Green River Community College? ❏ Fall/Sept.
❏ Winter/Jan.
❏ Spring/March ❏ Summer/June Year: ______________________________
What will you study? Check all programs that relate to your studies at Green River Community College. You may check more than one box. ❏ University Transfer
❏ Intensive English (IESL)
❏ High School Completion Plus
❏ Associate Degree
❏ Certificate
❏ Special program, which one? _________________________
What subject (major) do you plan to study? ______________________________________________________________________ Approximately how long will you attend? ❏ 3 months/1 quarter ❏ 6 months/2 quarters ❏ 9 months/academic year ❏ more than 1 year University Transfer Pathways: A letter of admission to a 4-year university may be requested at the same time you apply for Green River Community College. See website at greenriver.edu/international/utp/index.shtm for the most recent list of UTP universities. ❏ Yes – I request a UTP letter of admission to: ___________________________________________ Please fill in name of UTP university
Housing ❏ I will find my own housing (provide your U.S. address if known): __________________________________________________ Housing placements are made in the order completed applications and placement fees are received. Preferences are met based on availability. Green River has two housing choices for new applicants, Campus Corner Apartments or Homestay. What is your preference? Choice #1: ________________________________________________________________ Choice #2: ________________________________________________________________ Homestay Applicants Complete This Section This information will be provided to your prospective Host Family. What type of family do you prefer? (You may check more than one box.) ❏ Family without children
❏ Family with international students ❏ Family with small children ❏ Family with teenagers
Are there foods you cannot or will not eat?
❏ Yes
Do you smoke?
❏ No
❏ Yes
❏ No
What foods?__________________________________________ ❏ Sometimes
Do you have any religious requirements or preferences?____________________________________________________________ Campus Corner Apartment Applicants Complete This Section This information will be provided to CCA. Placements are made first-come, first-served. Preferences are met based on availability. I prefer:
❏ Females only
I prefer to share with:
❏ International students
❏ Males only
❏ No Preference
❏ Domestic (American) students ❏ Both
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Signature Page for Parents and Students International Student Admission Policy New students who use Green River’s I-20 to enter the U.S.A. must: Report in person to Green River’s orientation session for new international students; Enroll for and attend the first quarter at Green River; Carry Health Insurance while enrolled at Green River; Present originals of: passport, visa, and Green River’s I-20 - Students transferring from other U.S. schools must present their most recent I-20.
Medical Release The undersigned hereby gives to Green River Community College, its officers, employees, agents, and host families full authority and permission to take whatever action they feel is reasonably warranted under the circumstances, and to act as agent of the undersigned student and parent/ guardian, regarding the named student’s health and safety. This authority and permission includes, but is not necessarily limited to, the following: Rendering or ordering medical treatment; the giving of medication; and any examinations, X-rays, anesthetic, medical or surgical diagnosis or treatment or hospital care, if and as deemed necessary. The undersigned understands that a reasonable attempt will be made to contact the undersigned parent/guardian before any action is taken. The undersigned agrees to be financially responsible for all medical attention so authorized or ordered during the student’s attendance at Green River Community College. The undersigned represents that the named student has no medical restriction that limits his/her full participation in the programs and activities of Green River Community College, except as disclosed in any writing attached to this document. Permission is given for the student to participate in all activities offered at Green River Community College, except as restricted in any attached writing. To the fullest extent permitted by law, the undersigned hereby releases Green River Community College, its officers, employees, agents, and host families from all liability, and waive and release all claims, related to or arising from such decisions or actions as may be taken under the authority of this document.
Photograph/Image Release I consent to each use by Green River, and its officers, employees, and agents, of any photograph and likeness of me. Such use may include, but aren’t limited to, use in a program, catalogue, schedule, newspaper, web site, brochure, advertisement, or other publication or recording that describes, portrays, publicizes, or advertises the college or any college operation, and every reproduction, republication, or other re-use of the same. I also hereby waive any right to compensation for such uses, and any right to inspect or approve the uses beforehand. I hereby release Green River, its legal representatives and all persons acting under its permission or authority, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composition form, whether intentional or otherwise, that may occur or be produced in taking of said image.
By my signature below (Please check the following boxes): ❏ I verify that, to the best of my knowledge, all of the statements on this application form are true. I have read and agree to the published International Student Admission Policies. ❏ I authorize Green River Community College to release academic records and immigration status information to my sponsor, educational agency and or parents. ❏ I consent to use by Green River any likeness, image or photo of me for any official college program. ❏ I am either 16 or 17 years of age and understand that my parent/legal guardian will also sign this form before my application is considered complete.* ______________________________________ Student’s Name (please print)
________ Age
_______________________ Birthdate month/day/year
______________________________________ Student Signature
________________________ Today’s Date: month/day/year
______________________________________ *Parent/Legal Guardian’s Name (please print) ______________________________________ *Parent/Legal Guardian’s Signature
________________________ Today’s Date: month/day/year
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