SLIPPERY
ROCK UNIVERSITY OF PENNSYLVANIA
UNDERGRADUATE INTERNATIONAL STUDENT
APPLICATION
FOR ADMISSION
**NOTE: Please complete biographical information exactly as it appears in your passport**
1. DATE OF APPLICATION _________________________________
2. LAST, FAMILY OR SURNAME ______________________
FIRST ___________________ MIDDLE ____________________
3. DATE OF BIRTH __________________________________ (month/day/year)
4. MAILING ADDRESS (where admission materials and immigration forms can be sent): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. PERMANENT ADDRESS
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6. If the mailing address will change before your admission to Slippery Rock University, please identify how long we may reach you at that address _________________________________________________________________
7. If currently in the U.S.A, what type of visa do you hold? __________________
What is your Admission Number? _____________________________
If on a student visa, which institution issued your I-20 or IAP-66 form? _________________________________________________________________
8. When do you plan to enter Slippery Rock University? _________________________________________________________________
9. SEX: ___ Male ___ Female
10. MARITAL STATUS: ___ Single ___ Married
11. Number of Dependents ____________________
12. Please list any dependents coming to Slippery Rock University with you, and identify their name and relationship to you. _________________________________________________________________
13. CITY AND COUNTRY OF BIRTH _________________________________________________________________
14. COUNTRY OF PRESENT CITIZENSHIP _________________________________________________________________
15. What major and/or degree do you plan to pursue? _________________________________________________________________
16. Have you previously applied for admission to Slippery Rock University? If so, indicate when _________________________________________________________________
17. How long do you plan to attend Slippery Rock University?
___ one semester ___ one year ___ two years ___ three years ___ four years
18. Date you took or intend to take:
_________ TOEFL _________ SAT __________ Other
19. Name of parent, guardian or spouse _________________________________________________________________
20. Address of parent, guardian or spouse __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
21. Telephone number of parent, guardian or spouse (include area or city code)
_________________________________________________________________
22. Fax number where we may reach you _________________________________________________________________
23. E-mail address where we may reach you _________________________________________________________________
24. Names and addresses of close friends and/or relatives living in the U.S.A
________________________________________________________________________________________________________________________________________________
25. EDUCATION SUMMARY
Complete all columns for each school you attended, beginning with primary or elementary school and ending with your current or most recent school. Do not try to describe your education in terms of the United States educational system unless you have attended U.S schools. Use the terms familiar to your country. Attach an additional sheet of paper if necessary.
Column 1) School name.
Column 2) The city and country where the school is located.
Column 3) The month and year you began studies at the school; the month and year you finished.
Column 4) The kind of school, for example: elementary, gymnasium, lycee, colegio, university.
Column 5) The name of external examinations you took or expect to take before you come to Slippery Rock University, and the name of certificates, diplomas, or degrees you received or expect to receive before you come to Slippery Rock. For example: HKCE, GCE A-Levels, MCE, HSC, WASC, Abitur, Bachillerato, Baccalaureat, Associate Degree. List all education you completed or expect to complete before coming to Slippery Rock University. Give all results, including failures.
Column 6) The date of external examinations in column 5 and/or the date certificates, diplomas, or degrees in column 5 were awarded.
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1 |
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3 |
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5 |
6 |
School Name |
Location of School |
Dates of attendance |
Type of school |
Diplomas, Degrees |
Date received |
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ON A SEPARATE PIECE OF PAPER, PLEASE ANSWER ALL FIVE OF THE FOLLOWING QUESTIONS.
26. If you are not currently attending school, please provide details of your activities since you left school.
27. How did you first learn about SRU?
28. What attracts you to study in the United States and Slippery Rock University in particular?
29. In addition to courses in your major/degree program, what other subjects interest you?
30. Please describe your hobbies and interests.
31. Please read and sign
I understand that if my application is approved for admission and I choose to enroll at Slippery Rock University, I agree to observe all of the rules and regulations of the University and to pay all fees and charges assessed. I also certify that the information given on this application is complete and correct to the best of my knowledge. Misrepresentation in this application and supporting documents, as well as violations of the rules and regulations of the University or the inability to pay for expenses incurred may result in refusal of admission or dismissal from the University. I understand that all admissions materials as requested on the front of the application become the property of the University and will not be returned or forwarded to other institutions.
SIGNATURE _______________________ DATE ________________________
Slippery Rock University is committed to providing leadership in taking affirmative action to attain equal educational and employment rights for all persons, without regard to race, sex, handicap, or other legally protected classification. This policy is placed in this document in accordance with state and federal laws including Title IX of the Educational Amendments of 1972 and Section 504 of the Rehabilitation Act of 1973. Please direct equal opportunity inquiries to the Office of Social Equity, 108 Old Main, Slippery Rock, PA 16057-9989.