International Application for Admission

Please include with this application: $20 Application fee   Copy of your high school transcripts (and college transcripts, if applicable)   Completed Declaration of Finances form.

I am applying for admission as a:  First-Year Student  Transfer Student  Part-Time/Non-Degree/Other Student   I am applying for term beginning (complete year):  Fall (August 20_____)  Spring (January 20_____)

Personal Information________________________________________________________

Full Legal Name:    Male   Female   Email: ________________________________________

____________________________________________ Last Name   _________________________________ First Name   _______________________ Middle Name

Home Address:

_________________________________________________________________________________________________________ Complete Address

Address for Reply (if different from home address):

_________________________________________________________________________________________________________ Complete Address

________________________________________________________ Telephone Number (Country Code / City Code / Area Code / Number)

Date of Birth: ____/____/_____ (mm/dd/yyyy)

Country of Birth: _____________________________   Country of Citizenship: _____________________________

Single   Married

Parents' Information:

_________________________________________________________________________ Father's Full Name   Living?  Yes    No   _________________________________________________________________________ Mother's Full Name   Living?  Yes    No

__________________________________________________ Father's Occupation   __________________________________________________ Mother's Occupation

Number of Brothers and Sisters: __________

Parent's Marital Status: Married    Single    Divorced/Separated

How did you first learn about Jamestown College?   ________________________________________________________________________________________________________

What are your reasons for wanting to attend college in the United States?   ________________________________________________________________________________________________________

What are your plans after graduating from College?   ________________________________________________________________________________________________________

How long do you desire to study at Jamestown College? ________Years

Do you plan to graduate from Jamestown College?  Yes    No

What is the primary language in your country? __________________________

Have you ever been convicted of, plead guilty or no contest to, or entered into a plea agreement with respect to a crime resulting in imprisonment, probation, or court or administrative supervision?   Yes   No

If yes, please provide the date of arrest, case number, name, and address of the court, sentence imposed, and current status:   __________________________________________________________________________________________________________   __________________________________________________________________________________________________________

Have you ever been subject to any penalties, either scholastic or disciplinary, at any college or university?   Yes   No

If yes, when, where, why:   __________________________________________________________________________________________________________   __________________________________________________________________________________________________________

Previous Education________________________________________________________

School or University*   (most recent school first):

________________________________________ Name   _____________________________ Location   ___________ to ___________ Period of Attendance (mm/yyyy)   ________________________________________________________________________ Major Field of Study   ________________________________________ Name   _____________________________ Location   ___________ to ___________ Period of Attendance (mm/yyyy)   ________________________________________________________________________ Major Field of Study   ________________________________________ Name   _____________________________ Location   ___________ to ___________ Period of Attendance (mm/yyyy)   ________________________________________________________________________ Major Field of Study

* Please include with this application records of all completed secondary and university coursework. The record should include a clear explanation of the grading system.

Have you taken the Test of English as a Foreign Languages (TOEFL)?  Yes  Score:_________    No   Composite ACT (if known): ___________   Composite SAT (if known): ___________