Verlory And Eddie

International Application for Admission College of Business | College of Engineering & Computer Sciences | College of General Studies

name:

date: Enrollment Checklist* $50 application fee International Application for Admission True copies of high school records with certified translations True copies of college level records with certified translations (if applicable) SAT scores (if applicable)

TOEFL or IELTS score (if applicable) International student financial certificate (on back) Statement of financial resources from sponsor, such as bank statement Outside evaluation of credit if non U.S. university (if applicable)

* Your application will not be processed until all parts of the enrollment checklist have been received.

Cash/Check/Money Order Credit Card (circle one) VISA - MASTERCARD - DISCOVER - AMEX Card # _________________________________________________ Security code (3 digits found on back of card) ________ Exp. date _________ Cardholders Name (print) _________________________________ Signature ______________________________________________

An application fee of $50.00 USD must accompany this application.

(*see authorization statement on back of application)

Personal Information Full Legal Name:_______________________________________________________________________________

Last Name (Surname)

First Name

Middle Name

Permanent Address: ________________________________________ Present Mailing Address: _______________________________________ Number and Street Number and Street _________________________________________________________ ____________________________________________________________ City

State or Province

City

_________________________________________________________ Country

Postal Code

State or Province

____________________________________________________________

Country

Postal Code

Telephone: (______) ________________________________________

Cell: (__) _____________________ Fax: (__) _______________________

E-mail: ___________________________________________________

Birthdate: ___________________________ Sex:





Month

Day

Year

Male

Female

Country of Birth: ______________________________________________ Country of Citizenship: _________________________________________ Present Visa Status (if applicable): ________________________________

Admission Information Application for enrollment in 20____ Housing Plans:

On Campus

August (Fall)

Off Campus

January (Spring)

With Family

Have you ever applied for admission to or been enrolled at Indiana Tech?

Degree Information

Yes

Check if applying as:

Freshman

Transfer

SAT or ACT taken

Yes

No

No



If yes, when? __________________________

Please indicate your first and second choice by denoting 1 and 2

2-Year Associate Degrees

4-Year Bachelor’s Degrees

Business

Business & Arts

___ Accounting, A.S. ___ Business Administration/Management, A.S. ___ Recreation Management, A.S.

___ Accounting, B.S. Business Administration, B.S. ___ Health Care Administration ___ Human Resources ___ Management ___ Marketing ___ Sports Management ___ Communications, B.A. ___ Psychology, B.S. Recreation Management, B.S. ___ General ___ Sports Management ___ Therapeutic Recreation, B.S. ___ Elementary Education, B.S. Criminal Justice, B.S. ___ Law Enforcement Administration ___ Crime Analysis

Criminal Science ___ Criminal Justice, A.S.

Computer Studies ___ Graphic Communications, A.S. ___ Network Management, A.S. ___ Web Design, A.S.

Engineering ___ Biomedical Engineering, B.S. ___ Computer Engineering, B.S. ___ Electrical Engineering, B.S. ___ Industrial and Manufacturing Engineering, B.S. ___ Mechanical Engineering, B.S. ___ Energy Engineering, B.S.

Computer Studies ___ Computer Security & Investigation, B.S. ___ Computer Science, B.A. ___ Computer Science, B.S. ___ Information Systems, B.A. ___ Information Systems, B.S. ___ Networking, B.S. ___ Software Engineering, B.S. ___ Web Development, B.S.

Parent/Family Information With whom do you make your permanent home? (circle one)

Parent

Guardian

Spouse

Other

______________________

Name of above_________________________________________________ Occupation of listed name: __________________________________ Address: _________________________________________________________________________________________________________________ Number and Street

City

State or Province

Country

Name of friend or relative living in U.S.: ____________________________________________ Relationship to you: __________________________ Address: ______________________________________________________________________Telephone: (__) ______________________________ Number and Street

City

State

Zip

If other members of your family will enter the U.S. on your visa, list names and relationships to you: ________________________________________________________________________________________________________________________

Elementary, High School and College Information List below in chronological order (with dates) every school you have attended from the time you entered elementary school to present time. List the name of the instiution and indicate the type or kind of institution, such as kindergarten, elementary, high school, college, etc. It is necessary that certified/official attested copies of all educational records from high school level onward accompany this application. All records should be in English. If the language of the document is not in English, a certified translation must be included with the original document. Name of Institution

Type

Date Entered

Location (City/Country)

Date Exited

Certification/Degree or Diploma

Have you previously attended or are you now attending any college or university in the United State? Yes No If you have attended another college or university in the U.S., you should request that an official transcript of this work be forwarded to us directly from the institution. If you are transfering from another U.S. institution, the college must issue a transfer release before Indiana Tech can issue a valid I-20. Are you seeking transfer credit from any university outside the U.S.?

Yes

No

Have you ever been dismissed or placed on probation by any high school or institution of higher education?

Yes No If yes, please explain: ______________________________________________________________________________________________________ List Academic Honors Earned (Honor Societies, etc.): ____________________________________________________________________________ ________________________________________________________________________________________________________________________ Indicate activities, offices held in secondary school, and years of participation (Sports, Student Government, Publications, Music, Theatre, Civic Groups, etc.): _____________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ To which other colleges do you plan to apply for admission? ______________________________________________________________________

Financial Support Information In order to process your admission to the university, you and your financial sponsor must complete the International Student Financial Certificate form on the back side of this application and submit it with a current bank statement from your sponsor. The bank statement must show that there are adequate funds available for your educational expenses. Do not submit your application without this information.

English Proficiency TOEFL or IELTS Test taken? Yes No

TOEFL score __________ TOEFL test taken on:

IELTS score __________ Computer Paper

Internet

Official score reports must be submitted for students reporting test results. All lectures and textbooks are in English. You must be able to speak and write English well and to understand both written and spoken English. Applicants from countries where English is not the official language and who have not been educated in an English curriculum will need to prove their English skills.

Verification I certify the information is true and complete to the best of my knowledge. Falsification of information on this application could jeopardize acceptance and enrollment. I understand that my application will not be processed until all parts of the enrollment checklist have been received. I authorize any schools or colleges I have previously attended to release personal and academic information to Indiana Tech. Date: ___________________ Student Signature: ________________________________________________________________________________ Indiana Tech does not discriminate against employees, students, or applicants on the basis of race, sex, handicap, age, veteran status, national origin, religion, or political affiliation. If there is additional information you feel would be helpful to the committee in reviewing your application, please attach a separate sheet.

International Student Financial Certificate You are required to certify that you will have a minimum of $32,000 USD available for your first academic year at Indiana Tech and each year in attendance thereafter, exclusive of travel expenses. In computing your resources, you should bear in mind that you will not be allowed to work while attending college. You and your financial sponsor must complete this form providing all the requested information. This form must also be accompanied by a bank statement or other statement of financial resources for your sponsor, verifying adequate funds for your education. If your sponsor resides in the United States, they must complete the Immigration and Naturalization Service Form I-134. You should keep the original of Form I - 134 for the visa application process and forward a copy to this institution. NAME OF APPLICANT _________________________________________________________________________________________________ Last name (Surname) First Name Middle Name Amount of U.S. dollars you will have available while attending college in the U.S.: $______________________ per month x 12 months = $______________________ per year INDICATE THE SPECIFIC SOURCE OF THESE FUNDS AS FOLLOWS: Member of your family Name of family sponsor __________________________________________________________ Relationship to you ______________________________________________________________



Sponsorship by government, agency, person other than family member ________________________________________________________________________________________________________________ Name of sponsoring entity

Please provide a certified statement of support by sponsor and certified bank statements showing sponsor’s sufficient funds. Please note that both documents must be official translations of certified documents in English and U.S. dollars.

* Credit Card Authorization statement: I certify that all information provided is correct. By submitting this information, I authorize Indiana Institute of Technology to charge the specified amount and for the purpose indicated. Please be advised that any errors in processing are the sole responsibility of the cardholder. Disputes of transactions may result in additional processing fees charged to the cardholder.

Rev. 11/08 Office of Admissions 1600 E. Washington Blvd. Fort Wayne, IN 46803

800.937.2448 260.422.5561 x2205 260.422.7696 fax

www.IndianaTech.edu