Gavilan College

INTERNATIONAL STUDENT APPLICATION

(F-1 Student Visa)

College you are applying to: Gavilan College

Indicate Semester Start Date: Fall Semester 19___ Spring Semester 19___ Summer Session 19___ NAME_______________________________________________________________________________________________ last (family) first middle

DATE OF BIRTH ____/_____/________ SEX Male____ Female____ -----------------------month-- day--- year

HOME ADDRESS__________________________________________________________ __________________________________________________________________________

COUNTRY OF BIRTH__________________________________ COUNTRY OF CITIZENSHIP ___________________________

HOME COUNTRY PHONE ___________________________________ FAX_____________________

U.S. ADDRESS (if known): ____________________________________________________________________________ number----- street---------------------------- city------------------------------ state---------- zip

U.S. PHONE _______________________________________ Email/FAX_________________________________________

COURSE OBJECTIVE : Certificate Of Achievement Associate Degree Transfer to 4-year university or college

MAJOR FIELD OF STUDY______________________________________________________________________________

ENGLISH PROFICIENCY: Have you taken the TOEFL Test? yes no If yes, when (month/year)? _______________

If you have taken the TOEFL, what is your score? ___________________________ [note: You are required to provide an official TOEFL Score Report to complete your application.]

EDUCATIONAL BACKGROUND: List the high school, college/university or language school you have attended. ----------------------------------/------------------/--------------------/--------------------------------------

School/College Attended City/Country Dates Attended Diploma/Degree [note: You will be required to provide official transcripts from the high school and college/university you have attended.] CERTIFICATION: "I certify that all statements on this form are true and complete to my best knowledge."

APPLICANT SIGNATURE: ________________________________________________ DATE___________________