Cabrillo College international Student appliCation for admiSSion
Cabrillo College International Student Office • 6500 Soquel Drive, Aptos, CA 95003-3197
Tel: 01.831.479.6200 • Fax: 01.831.479.5779 • Email: international@cabrillo.edu
SESSION APPLYING FOR
❑ Fall
Year:____________ Application deadline: July 1
❑ Spring Year:____________ Application deadline: December 1
YOU MUST COMPLETE ALL ITEMS. Please type or print clearly in black ink.
1. Student or
U.S. Social Security Number
13. Country of Birth$JUJ[FOTIJQ _____________________________________
14. Educational Goals What is the educational achievement you wish to
complete?
Leave blank if you do not have a student or U.S. Social Security number.
The college will issue a college ID once you have been accepted.
(Check only one)
2. Have you ever before submitted an application for admission to
Cabrillo College?
Year(s) _______________________
Yes
No
3. Last Name ___________________________________________________
(Family name as appears on your passport
First Name ________________________________ MJEEMF/BNF_________
(Given name as appears on your passport)
Street & Apt # _________________________________________________
City _________________________________ 1PTUBM$PEF_____________
Country _____________________________________________________
5. Permanent Home Country Address (If different from mailing address)
Street & Apt # _________________________________________________
___________________________________________________________
City __________________1PTUBM$PEF____________$PVOUSZ_____________
6. Home Phone __________________________________________________
.PCJMF Phone _________________________________@@@@@@@@@@@@@
7. Date of Birth
Age ________________
Day
Year
AC Chinese
AJ Japanese
AK Korean
AL Laotian
AM Cambodian
AV Vietnamese
AX Other Asian
9. Gender
❑
❑
❑
❑
❑
8 Update job skills
9 Maintain cert. or license
10 Intell./cultural development
11 Basic English/math/reading skills
12 Undecided
❑ 1 U.S. Citizen
❑ Non U.S. Citizen (Select one)
❑ 2 Permanent Resident
Alien number __________________________________________________
❑ 3 Temporary Resident/Amnesty
Alien number __________________________________________________
❑ 4 Refugee/Asylee
Alien number ___________________________________________________
❑ 5 Student Visa (F-1)
❑ 6 Other Status _______________________________ I-94 expires ___________
16. Is English the language you usually speak at home?
Yes
No
17. Release my Directory Information to the public.
Yes
No
“Directory Information” at Cabrillo College includes the following only: student name, telephone
number and address.
18. Highest level of education you have completed (Select one)
8. Ethnicity (Select one)
❑
❑
❑
❑
❑
❑
❑
1 BA/BS after AA/AS
2 BA/BS without AA/AS
3 AA/AS without transfer
4 Voc. Degree without transfer
5 Voc. Cert. without transfer
6 Formulate career plans
7 Acquire job skills
15. Citizenship (Select one)
4. Mailing Address (I-20 will be mailed to this address)
Month
❑
❑
❑
❑
❑
❑
❑
❑ B Black, Non-Hispanic
❑ F Filipino
❑ HM Mexican, Mexican
American
❑ HR Central American
❑ HS South American
❑ HX Other Hispanic
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
N American Indian
O Other Non-White
PG Guamanian
PH Hawaiian
PS Samoan
PX Other Pacific Islander
W White, Non-Hispanic
❑ Female ❑ Male
1 Not grad/no longer in HS
2 HS enrichment/enrolled K–12
3 Currently in Adult School
4 HS graduate
5 Received GED/Cert. of Equivalency
6 Received Cert. HS Proficiency
7 Foreign secondary diploma
8 Received associate degree
9 Received bachelor’s degree or higher
10. Email Address _________________________________________________
19. I will arrive at Cabrillo College from
11. Major (Select one)
____________________________________________________________(Home Country)
(See page 2 for Major Code)
orUSBOTGFSGSPN
___________________________________________________________ (Location in U.S.)
Name of Major________________________________________________________________
12. Admission Status (Check one)
❑ 1 New (first-time college student)
❑ 2 New Transfer (attended college, but not Cabrillo)
❑ 3 Re-Entering Transfer
(attended Cabrillo in the past, but last attended ______ ____________)
❑ 4 Re-Entering (last college attended was Cabrillo, but not last semester)
Date of last attendance at Cabrillo (semester/year) _______________________
OC
CC
Datatel #:
If you are a student residing in the United States with F-1 status, please list the name and
address of the school you are currently attending.
__________________________________________________________________________
Initials: ______
Enter Date: _______
20. Write in order, by year, all schools you have attended. Begin with your most recent educational institution.
Name of school
or institution
Location of school
(city, country)
Type of school
(high school,
college, etc.)
21. Visa Information (POMZif transferring from another educational institution in the U.S.)
Passport # _____________________________________________________
Country of Issuance _____________________________________________
Date Passport Expires ____________________________________________
Type of visa you originally entered the United States with ______________
Visa Expiration Date _____________________________________________
I-94 Expiration Date _____________________________________________
Current Visa Status ______________________________________________
If you applied for a change of status, what was the date your application was filed?
(Please enclose a photocopy of application) ____________________________________________
SEVIS ID#_____________________________________________________
22. Contact information. Please list a relative or person we can contact in the case of an
emergency.
Name________________________________________________________
Relationship to you (parents, spouse, etc.) _____________________________
Attendance
dates
Your age
at end of
study
Degree/
Date received
23. Will any family members be traveling with you? If so, list their names, citizenship,
gender, and date of birth on a separate sheet of paper, for example:
____________________________________________________________
Full Name
Gender
DOB
Citizenship
24. Please read and check the following statements.
I understand that I must fulfill the following requirements before the
International Student Admission Committee will evaluate my application
for admission as an F-1 student:
❏
❏
❏
❏
❏
❏
Completed application, dated and signed
Application fee of $60 (nonrefundable)QBJECZDIFDLPSNPOFZPSEFS
Official transcripts in English
Official TOEFL score of 480/157/54 or higher
Financial Certification Statement
Photocopy of QBTTQPSU*%WJTBI-94, I-20 (only for studentsDVSSFOUMZTUVEZJOHJOUIF64
25. I declare that I have read and understand the requirements for admission and will
comply with all college and immigration regulations. I declare under penalty of perjury
that the statements submitted by me are true and correct. All materials submitted by
me for purposes of admission become property of Cabrillo College.
Signature_____________________________________Date_____________
Address ______________________________________________________
Phone Number(s) (include country code) ________________________________
.PCJMFNumber ________________ Email_____________________________
Major Codes‐Use to complete application (question number 11) Major Codes–Use to complete application (question number 1)
Accounting . . . . . . . . . . . . . . . . . . . . . . . . . 050200A
Administrative Support . . . . . . . . . . . . . . . . 051400B
American Studies . . . . . . . . . . . . . . . . . . . . . 220120
Anthropology. . . . . . . . . . . . . . . . . . . . . . . . . 220200
Art History . . . . . . . . . . . . . . . . . . . . . . . . . 100200A
Art Photography . . . . . . . . . . . . . . . . . . . . . 100200C
Art Studio . . . . . . . . . . . . . . . . . . . . . . . . . . 100200B
Asian Studies . . . . . . . . . . . . . . . . . . . . . . . . 221010
Astronomy. . . . . . . . . . . . . . . . . . . . . . . . . . . 191100
Bilingual/Bicultural Studies . . . . . . . . . . . . . . 220300
Biology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 040100
Building Inspection . . . . . . . . . . . . . . . . . . . 095720A
Business . . . . . . . . . . . . . . . . . . . . . . . . . . . . 050100
Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . 190500
Communication Studies . . . . . . . . . . . . . . . . 150600
Computer Bus. Applications . . . . . . . . . . . . . 051400A
Computer Networking/System Admin. . . . . . . . 070810
Computer Science (transfer) . . . . . . . . . . . . 070600
Computer Science (programming) . . . . . . . 070710
Computer Support Specialist . . . . . . . . . . . . 070820
Construction & Energy Mgmt. . . . . . . . . . . . . . . 095700
Criminal Justice: Corrections . . . . . . . . . . . . . . . 210510
Criminal Justice:
Law Enforcement . . . . . . . . . . . . . . . . . . . . . 210500
Culinary Arts & Hospitality Mgt.. . . . . . . . . 130630A
Dance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100800
Dental Hygiene . . . . . . . . . . . . . . . . . . . . . . . 124020
Digital Publishing . . . . . . . . . . . . . . . . . . . . . 061400
Digital Management,
Career Preparation (DMCP). . . . . . . . . . . . . 499900
Early Childhood Education . . . . . . . . . . . . . . 130500
Economics . . . . . . . . . . . . . . . . . . . . . . . . . . 220400
Engineering. . . . . . . . . . . . . . . . . . . . . . . . . . 090100
Engineering Technology . . . . . . . . . . . . . . . . 092400
English . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150100
Fire Service Management . . . . . . . . . . . . . 213300B
Fire Technology . . . . . . . . . . . . . . . . . . . . . 213300A
French. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110200
Geography . . . . . . . . . . . . . . . . . . . . . . . . . . 220600
Geology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191400
German. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110300
Health Science/Community Health. . . . . . . . 083700
History. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220500
Horticulture, Gen. & Crop Production . . . . 010900A
Horticulture, Landscape . . . . . . . . . . . . . . . 010910A
Human Services. . . . . . . . . . . . . . . . . . . . . 210400A
International Studies. . . . . . . . . . . . . . . . . . . 221000
Journalism . . . . . . . . . . . . . . . . . . . . . . . . . 060200A
Liberal Arts (transfer) . . . . . . . . . . . . . . . . . . 490110
Liberal Arts and Sciences . . . . . . . . . . . . . . 490100
Liberal Studies (for Elementary Teaching) . . 490120
Mathematics . . . . . . . . . . . . . . . . . . . . . . . . . 170100
Medical Assistant . . . . . . . . . . . . . . . . . . . . . 120800
Medical Insurance Specialist . . . . . . . . . . . 051420A
Music. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100400
Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123010
Philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . 150900
Physical Education . . . . . . . . . . . . . . . . . . . . 083500
Physics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190200
Political Science . . . . . . . . . . . . . . . . . . . . . . 220700
Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . 200100
Radiologic Technology . . . . . . . . . . . . . . . . 122500A
Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 490200
Social Science . . . . . . . . . . . . . . . . . . . . . . . 220100
Sociology . . . . . . . . . . . . . . . . . . . . . . . . . . . 220800
Spanish. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110500
Theatre Arts . . . . . . . . . . . . . . . . . . . . . . . . . 100700
Undeclared/Undecided . . . . . . . . . . . . . . . . . 000001
Web Media . . . . . . . . . . . . . . . . . . . . . . . . . . 061430
Welding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 095650
Cabrillo College International Student Confidential Financial Certification Statement
All students applying for F-1 student visa status admission must show the availability of $17,056 for one year of study.
Please complete the following information and submit with supporting documentation. All monies must be shown in
the equivalent of U.S. dollars.
Name of Applicant_______________________________________________________________________________________________________________
Last/Family name as appears on passport
First/Given name as appears on passport
Estimated minimum student expenses for a
9-month academic year (and optional summer)
Tuition/fees _______________________________________ $
Tuition estimates are based on a minimum of 12 units per semester.
Tuition and fees will increase if students enroll in more than 12 units.
Books/supplies _________________________________________
Health insurance (mandatory) ____________________________1200
Estimated living expenses NPOUIT
_____________________,000
TOTAL __________________________________________ $17,056
Summer (optional) ____________________________________ $4,000
Dependents (optional) _____________________________ $4000 each
Sponsor Source
Documentation Required
Guaranteed Funds (U.S. $)
Personal savings
Official letterPSTUBUFNFOU from bank
$
Parents
Letter of guarantee from parents
and bank letter
$
Relatives/friends
Letter of guarantee and bank letter
$
Sponsor
Letter of guarantee and bank letter
$
Government support
Official letter confirming type
and amount of funding
$
Other
Letter of guarantee and bank
verification
$
Subtotal
+ $4,000 for spouse
+ $2,500 for each dependent
$
$
$
TOTALS
$
I declare under penalty of perjury that the above statements are true and correct. I understand that there is no financial assistance
available to international students and it is my responsibility to pay for all costs incurred while studying at Cabrillo College.
Student’s Signature_________________________________________________________
Date___________________________
Cabrillo College international Student appliCation for admiSSion
How to Apply
Complete all sections of the application form and submit with:
$60 non-refundable application feeQBJECZDIFDLPSNPOFZPSEFSNBEFPVUUP$BCSJMMP$PMMFHF
4upporting financial information
0fficial transcripts in English
0GGJDJBM50&'-UFTUSFTVMUT
$PQZPGQBTTQPSU*%QBHF Submit application package by the deadline to:
Cabrillo College
International
Student Office
6500
Soquel Drive
Aptos,
CA 95003
USA
Once
your complete application is reviewed, you will receive an
admission
package with your I-20 form and detailed directions on
applying for an F-1 student visa.