InternationalStudent

SupplementalApplication

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Thisapplicationformisforinternationalstudentapplicants(non-U.S.citizensandnon-residentaliens.)IfyouareaU.S.citizenorresidentalien,youwillonlyneedtosubmitNTC’sgeneralapplicationform.NTCapplicationformsareavailableonlineatntc.edu.

Pleasenote:informationrequestedonthisformwillbeusedtocompletetheCertificateofVisaEligibilityforNonimmigrantF-1StudentStatus,commonlyknownastheI-20from.Thisisthedocumentissuedbyaschoolthroughtheinternet-basedStudentandExchangeVisitorInformationSystem(SEVIS)forpresentationataU.S.consulateabroadtoapplyforanF-1Studentvisa;itmustalsobepresentedtoanimmigrationofficialuponentryintotheU.S.

YourpassportandI-20formMUSTmatchinorderforyoutobeissuedanF-1visaandbeadmittedintotheUnitedStatestostudy.PleasePRINTyourinformationEXACTLYasitappearsinyourpassport.

FamilyName(Surname):_____________________________________mi__________________________

GivenName(FirstName):________________________________________________________________

MiddleName(ifapplicable):______________________________________________________________

U.S.SocialSecurityNumber:________-________-_______(leaveblankifyoudonothaveone)

€Male €Female

Dateofbirth:Month:__________Day:_______Year:____________CountryofBirth:______________

CountryofCitizenship:______________________CountryofResidence:_________________________

IntendedProgramofStudyatNTC:________________________________________________________

IfyouarecurrentlyintheUnitedStates,yourimmigrationstatus:€F-1€J-1€B-1Other:_______

VisaExpirationDate:___________Admission/DepartureNumberonyourI-94_____________________

YourPassportNumber:_________________________PassportExpirationDate:___________________

MaritalStatus:€NotMarried€Married

Ifyouaremarried,willyourspouseaccompanyyoutotheUSA?€Yes€No

Ifyouhavechildren,howmanywillaccompanyyoutotheUnitedStates?_________________________

Onaseparatesheetofpaper,pleaselistthecompletenamesandbirthdatesofeachaccompanyingchildand/oryourspouse.Ifeitheryourspouseoryourchildrenwillaccompanyyou,remembertoshowincreasedfinancialsupportontheDeclarationofFinances.

Pleaseincludeyourcompletemailingaddress,asitshouldbewrittenonanenvelope(inEnglish):_________________________________________________________________________________________________________________________________________________________________

Phone:CountyCode_____CityCode____Number_________________

Fax:CountryCode_____CityCode_____Number__________________

E-mail:___________________________

Ifyouwishtoallowanotherpersontodiscussyourapplicationwithus,pleaseindicatethefollowing:

ContactPerson’sName:___________________________________________Relationship:__________

Pleaseincludetheirmailingaddress,asitshouldbewrittenonanenvelope(inEnglish)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Phone:CountryCode____CityCode___________Number____________________________________

Fax:CountryCode_______CityCode__________Number_____________________________________

E-mail:________________________________

Ifyouwishtoallowanotherpersontodiscussyourapplicationwithus,pleaseindicatethefollowing:

Doyouwishforallcorrespondencetobedirectedtothisperson?€Yes €No

Pleasecheckoneofthefollowing:

€ThisismyinitialattendanceatNTC

€IhaveattendedNTCpreviously Mylasttermwas__________

€Iamanf-1studenttransferfrom____________________________________________________(highschoolorcollegename.)Nameandcontactinformation(phoneande-mail)forpersonatthatinstitution:

________________________________________________________________________________________________________________________________________________________________________

Toensurereasonablesuccessintheclassroom,allstudentsapplyingtoNorthcentralTechnicalCollegemustdemonstrateproficiencyintheEnglishlanguage.InternationalstudentsgenerallyshowproficiencybytakingtheTestofEnglishasaForeignLanguage(TOEFL).Tobeacceptedintoafull-timeCollegedegreeprogram,aminimumscoreof(computertest),450(papertest),isrequired.

Itook(orwilltake)theofficialTOEFL(ifapplicable)on____________________________(Date)

Irequested(orwillrequest)thescorestobesentdirectlytotheNorthcentralTechnicalCollege()on_____________(Date)

MyotherproofofEnglishlanguageproficientis___________________________________________

STATEMENTOFFIANCIALRESOURCESDepartmentofHomelandSecurityregulationsrequireinstitutionstoobtainevidencestatinthatapplicantshaveadequatefinancialresourcestoprovidefortheirexpenseswhilestudyingintheUnitedStates.Fundsmaycomefromavarietyofresources,includingpersonalsavings,scholarships,sponsoringagencies,continuanceofsalary,theapplicant’sfamilyoranydependablesource.Allinternationalapplicants,thoseapplyingformoutsideandthosecurrentlylivingintheUnitedStates,mustfillouttheDeclarationofFinancesandsubmitsupportingevidenceoffunding.DECLARATIONOFFINANCESCurrentcostsforeachoftheprogramsattheNorthcentralTechnicalCollegemaybefoundon-lineatwww.ntc.eduIcertifythatIwillhaveadequatefundsformytraveltoandfromtheUnitedStates.€Yes €NoIcertifythatIcanmakethenecessaryarraignmentstohaveallfundstransferredtotheUnitesStates. €Yes €NoIcertifythatthesefundswillbeprovided(checkallthatapply): €Frommyownsavings €bymyparents €other(specify)____________________________________________________________________________Sponsor’sname:_____________________________________________________________________SignatureofSponsor:_________________________________________________________________Date:______________________________________Relationshipofsponsor:_____________________________TitleorOrganization_______________________Addressofsponsor:______________________________________________________________________________________________________________________________________________________________________________________Onaseparatepieceofpaper,pleaseprovidealistofeachofthesourcesthatwillbeusedtofundyourcostsatNTC.Thisshouldincludeseparateinformationfor1)personalfunds,2)familyfunds,3)scholarshipfunds,4)governmentfunds,and5)otherfunds.Pleaseincludename,relationship,address,occupation,guaranteestatement,andsignaturewithdateofindividualsthatwillhelpsupportyoureducationalexpenses.Readthefollowinginstructionsverycarefully.Pleasenotethatsupportmaycomefromoneorseveralsources.

• EnteramountsinU.S.dollars.• Entertheinformationrequestedabouteachapplicablesourceoffunds.• Enterthetotalamountoffundsthatwillbeavailableforeachyearofstudyfora12-monthperiod.• Remembertoencloseevidenceoffundsforeachindicatedsource.Statementsfrombanksorsavings,

representative,andmustspecifyamountofmoneyavailableinU.S.dollars.

IcertifythatalltheinformationIhaveprovidedistrueandcompleteandreflectsmyentireeducationalbackgroundasisnecessaryformylevelofentry.IalsocertifythatIwillprovideofficialdocumentsinsupportofmyeducationhistorytotheNorthcentralTechnicalCollege.Yoursignature____________________________________________________________________Date_______________________TheI-20willbeissuedwhenthisformisreturnedwiththeappropriateadditionaldocumentation.