CABRILLO COLLEGE INTERNATIONAL STUDENT APPLICATION FOR ADMISSION
Cabrillo College International Student Office • 6500 Soquel Drive, Aptos, CA 95003-3197
(831) 479-6200 • FAX (831) 479-6172 • E-mail: international@cabrillo.edu
SESSION APPLYING FOR
❑ Fall
❑ Spring
Year:____________ Application deadline: July 1
Year:____________ Application deadline: December 10
YOU MUST COMPLETE ALL ITEMS. Please type or print clearly in black ink.
1.
13. Place of Birth (State or country)__________________________________________
US Social Security Number
Leave blank if you do not have a student or Social Security number.
The college will issue a college ID once you have been accepted.
14. Educational Goals What is the educational achievement you wish to complete?
2. Have you ever before submitted an application for admission to
Yes
No
Cabrillo College?
Year(s) _______________________
3. Last Name ________________________________________________________
(Family name as appears on your passport)
First Name ___________________________________________ M.I._________
(Given name as appears on your passort)
4. Mailing Address (I-20 will be mailed to this address)
(Check only one)
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❑
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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
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8 Update job skills
9 Maintain cert. or license
10 Intell./cultural development
11 Basic English/math/reading skills
12 Undecided
15. Citizenship (Select one)
Street & Apt # _____________________________________________________
City________________________________State/Province__________________
Country _____________________________Zip___________________________
5. Residence Address (If different from mailing address)
Street & Apt # _____________________________________________________
City________________________________State/Province__________________
Country _____________________________Zip___________________________
❑ 1 U.S. Citizen
❑ 2 Non U.S. (Please specify)______________________________________
❑ Permanent Resident
Alien number _________________________________________________
❑ Temporary Resident/Amnesty
Alien number _________________________________________________
❑ Refugee/Asylee
Alien number _________________________________________________
❑ Student Visa (F1)
❑ 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.
6. Home Phone _______________________________________________________
Cell Phone ________________________________________________________
1
7. Date of Birth
Month
Day
9
Year
Age __________________
AC Chinese
AJ Japanese
AK Korean
AL Laotian
AM Cambodian
AV Vietnamese
AX Other Asian
9. Gender ❑ Female
❑ B Black, Non-Hispanic
❑ F Filipino
❑ HM Mexican, Mexican
American
❑ HR Central American
❑ HS South American
❑ HX Other Hispanic
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N American Indian
O Other Non-White
PG Guamanian
PH Hawaiian
PS Samoan
PX Other Pacific Islander
W White, Non-Hispanic
18. Highest level of education you have completed (Select one)
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
19. I will arrive at Cabrillo College from
❑ Male
10. E-mail Address _____________________________________________________
11. Major (Select one)
No
“Directory Information” at Cabrillo College includes the following only: student name, telephone number and address.
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❑
8. Ethnicity (Select one)
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❑
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❑
❑
Yes
__________________________________________________________ Home Country
or
_________________________________________________________Location in U.S.
(see page 2)
If you are a student residing in the United States on an F1 visa, please list the name and
address of the school you are currently attending.
(Major code)
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, but last attended _______________________ [another college])
❑ 4 Re-Entering (last college attended was Cabrillo, but not last semester)
Date of last attendance at Cabrillo (semester/year) ____________________________
OC
CC
Datatel #:
_____________________________________________________________________
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
Passport # ____________________________________________________________
Country of Issuance _____________________________________________________
Date Passport Expires ___________________________________________________
Type of visa you originally entered the United States with ________________________
Visa Expiration Date _____________________________________________________
I-94 Expiration Date _____________________________________________________
Attendance dates
Your age at end
of study
Degree/Date
received
23. 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 F1 student:
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Completed application, dated and signed
Application fee of $60 (nonrefundable)
Official transcripts in English
Official TOEFL score of 450/133 or higher
Financial Certification Statement
Photocopy of visa, I-94, I-20, and Transfer Release Form (form only for students
currently studying in the United States)
24. 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.
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) ____________________________________________
Signature__________________________________________Date_____________ _
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.) __________________________________
Address _____________________________________________________________
Phone Number(s) _____________________________________________________
Fax Number ____________________ E-mail _______________________________
MAJOR CODES
Use to complete item number 11.
Account Clerk.......................................... 051400C
Accounting ................................................ 050200
Administrative Assistant ......................... 051400A
American Studies .................................... 229900A
Anthropology ............................................ 220200
Applied Living Arts .................................... 130400
Archaeological Technology........................ 220220
Art History .............................................. 100200A
Art Studio................................................ 100200B
Asian Studies .......................................... 220210B
Astronomy ................................................ 191100
Bilingual/Bicultural Studies ..................... 220210A
Biology ..................................................... 040110
Building Inspection ................................... 095720
Business ................................................... 050100
Chemistry ................................................. 190500
Chinese ..................................................... 110700
Computer Information Systems .............. 079900A
Computer Science ..................................... 070100
Construction & Energy Mgmt ................... 095700
Criminal Justice: Corrections .................... 210510
Criminal Justice: Law Enforcement ........... 210500
Culinary Arts & Hospitality Mgmt ............. 130630
Dance ........................................................ 100800
Dental Hygienist ........................................ 120420
Digital Publishing .................................... 079900B
Early Childhood Education ...................... 130510A
Economics ................................................ 220400
Engineering, General ................................. 090100
Engineering Technology ............................ 092400
English ...................................................... 150100
Fire Service Management ........................ 213300B
Fire Technology ....................................... 213300A
French ....................................................... 110200
General Science ........................................ 490200
Geography ................................................ 220600
Geology..................................................... 191400
German ..................................................... 110300
Health Science/Community Health ............ 083700
History ...................................................... 220500
Horticulture: General & Crop Prod .......... 010900A
Horticulture: Greenhouse Design & Mgmt ............
010900B
International Studies ............................... 229900B
Italian ........................................................ 110400
Japanese ................................................... 110800
Journalism .............................................. 060200A
Landscape Horticulture ........................... 010910A
Liberal Arts & Sciences ........................... 490100A
Liberal Arts (Transfer) ............................. 490100B
Mathematics ............................................. 170100
Medical Assistant ...................................... 120370
Medical Insurance Specialist ................... 051420A
Medical Transcription .............................. 051420B
Multimedia ................................................ 109900
Music ........................................................ 100400
Nursing (Assoc Degree) ............................ 120300
Nursing (Voc)............................................ 120320
Office Assistant ....................................... 051400B
Philosophy ................................................ 150900
Physical Education .................................... 083500
Physics, General ....................................... 190200
Political Science ........................................ 220700
Psychology, General.................................. 200100
Radiologic Technology ............................ 122500A
Real Estate ................................................ 051100
Small Business Training Program ............. 059900
Sociology .................................................. 220800
Spanish ..................................................... 110500
Speech Communication ............................ 150600
Theatre Arts .............................................. 100700
Undecided/Undeclared .............................. 000000
Vocational Gardening .............................. 010910B
Women’s Studies ...................................... 220110
Cabrillo College International Student Confidential Financial Certification Statement
All students applying for F1 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
Sponsor Source
Documentation Required
Personal savings
Official letter 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
$
Letter of guarantee and bank
verification
$
Subtotal
+ $4,000 for spouse
+ $2,500 for each dependent
$
$
$
TOTALS
$
Other
Guaranteed Funds (U.S. $)
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__________________________