APPLICATION CHECKLIST

Transcription

1 APPLICATION CHECKLIST International students requesting admission to the Los Angeles Unified School District must be admitted through the Foreign Student Admissions Office, not the requested school. Schools may recommend the acceptance of an individual student but are unable to issue the documents required to obtain the F-1 Visa. A completed application consists of: LAUSD FOREIGN STUDENT ADMISSIONS APPLICATION STUDENT QUESTIONAIRE AUTHORIZATION FOR ADULT TO ACT AS GUARDIAN The natural/legal parent must authorize another adult to act on his/her behalf in all educational decisions and matters while the student is studying in the LAUSD. PHOTO RELEASE COPY OF PASSPORT STUDENT TRANSCRIPTS Official transcripts from all high schools attended must be submitted with the application. The transcripts must be in English and translated by a recognized translation service. HEALTH EXAM AND IMMUNIZATION RECORDS - The laws of the State of California require that before enrolling in school for the first time, a pupil must be immunized against diphtheria, tetanus, polio, measles, rubella, pertussis, varicella and hepatitis B (3 doses are required). This is to certify that the student named is in good health and is free from any impairment. All immunizations must be stamped by a doctor or clinic or a copy of the immunization record may be submitted in lieu of the form. The health exam must show that the student is free from any condition of concern which would affect the student s ability to participate in the program or any school activities. The exam should be conducted within six months of travel. PROOF OF MEDICAL INSURANCE COVERAGE - California Education Code 32220, et seq., requires that participants in school activities have accidental bodily injury insurance. Each student who participates in school activities must have insurance in the amount of, at least, $1, for medical/hospital benefits. The District strongly recommends that International Students have at least the requisite amount of health insurance for the entire length of the student stay. U.S. law requires proof that an international student will not in any way become a public charge to the United States. STATEMENT OF FINANCIAL SUPPORT - International students must present satisfactory evidence of adequate funds available to meet their financial obligations to the Los Angeles Unified Schools as well as living expenses. The estimated minimum cost of attending Los Angeles Unified School District for one academic year (10 months) is updated annually. Verification of funds may be supported by a bank, stock, bond, or property statement and indicate U.S. foreign exchange rate. COPY OF HOST GUARDIAN IDENTIFICATION VERIFICATION OF ADDRESS FOR HOST GUARDIAN (UTILITY BILL) ACKNOWLEDGEMENT OF F-1 INFORMATION: POLICIES AND PROCEDURES (SIGN OFF PAGE) All applicants are required to submit the documents listed above for District review. Upon notification of acceptance, the student will be invoiced for the cost of tuition and non-refundable processing fees. This amount must be paid in full prior to the issuance of the I-20.

2 APPLICATION FOR FOREIGN STUDENT ADMISSION Academic School Year: Fall Semester Spring Semester Both School/s Requested: 1 st Choice: STUDENT INFORMATION 2 nd Choice: Estimated Date of Entry to U.S.A.: Last Name (Family Name) First Name Middle Name Suffix Date of Birth (month, date, year) Gender M Address F Country of Birth Country of Citizenship Grade Requested City Province/Territory Postal Code Country Student s Address (if applicable) Student s Home Phone Number FAMILY INFORMATION IN HOME COUNTRY Father s Last Name (Family) First Name Mother s Last Name (Family) First Name Address Check if information is the same as above Home Phone Home Address Father s Cell Number Mother s Cell Number Emergency Contact Name Relationship Contact Number Address GUARDIAN OR CONTACT PERSON INFORMATION IN THE UNITED STATES The Student will live with: (Please Check) Host Family Relative Name(s): Relationship to student: Address City State Zip Home Phone Home Address Work Phone Number Cell Phone Number Cell Phone Number AGENCY INFORMATION (if applicable) All agencies must be currently listed on the California Attorney General s Registry of International Student Exchange Visitor Placement Organizations (ISEVPO) in order to place students within the LAUSD. Name of Agency Local Contact Person/Representative Address of Local Contact City State (Country) Zip Code Address of National Headquarters City State (Country) Zip Code Phone Number of Local Contact Address of Local Contact Phone Number of National Office Agency Website Is the student proficient in English (not a requirement for F-1 status) (Circle one) YES NO Has the student completed a high school program or equivalent? (Circle one) YES NO Does this student have any special physical or academic needs? (Circle one) YES NO Is the student currently under expulsion from another school/program? (Circle one) YES NO

3 FOREIGN STUDENT ADMISSIONS QUESTIONNAIRE Thank you for your interest in the Los Angeles Unified School District. In order to better assist with your school placement, we would like to know more about you. Please answer the following questions as honestly as possible. 1. Why would you like to attend the LAUSD? 2. What is your main educational goal? (Circle yes or no) Earn a U.S. High School Diploma Yes No Transfer to a Community College Yes No Transfer to a Four-Year College or University Yes No Return to your home country to complete your studies Yes No 3. What type of job/career are you interested in? 4. Have you previously participated in an exchange program or studied abroad as an F-1 student? (Circle yes or no) Yes No If yes, please tell us about your experience. Include where you studied, program length, and current enrollment. 5. The following are a few of the programs which may be available at some schools. Please select the ones that interest you and explain why. What are your favorite subjects in school? Visual or Performing Arts Math/Science School of Business and Technology Media Academy Education Humanities Other 6. What clubs or activities have you participated in? What are your hobbies or special interests? 7. Tell us a little more about you, including your future goals, experiences, likes/dislikes. PRINT NAME: BIRTHDATE: DATE: Date Received: Reviewed By:

4 AUTHORIZATION FOR ADULT TO ACT AS GUARDIAN I, (We) and/or Name of Legal Parent Name of Legal Parent do hereby state that I am (we are) the natural or legal parents of, Name of Student a minor, age, born on. I (We) authorize Date Host Guardian Name and to act on my (our) behalf in all educational decisions and Additional Host Guardian/Agency Name matters, including, but not limited to registration and enrollment, authorizing absences, field trips, acknowledging notifications and signing other authorizations including, but not limited to, medical decisions and treatment in accordance with provisions of California Education Code and/or I have read and understand the Foreign Student Information including the tuition, processing fees and refund policy. I certify under penalty of perjury under the laws of California that the above information is true and correct. Dated this day of, 20 at. Number Month Year Location of Signing Print Natural/Legal Parent Name Signature Witnessed by: Print Natural/Legal Parent Name Signature Date: *THIS DOCUMENT MUST BE OFFICIALLY NOTARIZED* Upon review, an agency authorization may be accepted in lieu of the LAUSD Authorization for Adult to Act as Guardian. Please note that the agency form must be signed by the natural or legal parent/s.

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