Oklahoma Panhandle State University Application Package

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1 Oklahoma Panhandle State University Application Package Step 1 Step 2 Application Form: Each section of the application must be complete and it must be signed. Official Transcripts - Please do not submit photocopies of any awards or extracurricular accomplishments. Secondary school transcripts, English proficiency waivers, and WAEC results should be sent by the student s secondary school in a sealed envelope. Secondary School Transcripts: International students must have the equivalent high-school education from their country. Your high school will need to submit the official transcripts (transcript of course work with secondary school stamp or seal) in a sealed envelope. The transcript must be in English or be a certified translation. U.S. College Transcripts: If you are a transfer student from a U.S. institution of Higher Learning, you will need to submit official transcripts (transcript of course work) from each institution. You will also need to fill out a transfer form that can be obtained from the International Students Office. Foreign College Transcripts: If you are a transfer student from an institution outside the U.S., you will need to submit a Course by Course description report from a specialized foreign credential evaluation organization. Step 3 Step 4 Diploma: Students must submit an official copy of their certificate showing completion of secondary school (i.e. exam results). If you took the WAEC exam, please request WAEC or your high school to send your results directly to OPSU. You may also mail your scratch card for confirmation of your results online. English Proficiency: TOEFL score: Official score of 500 paper-based or 173 computer-based is required for all students whose English is a second language. IELTS score: Official score of 6.0 or higher is also acceptable. English proficiency waiver: A waiver of English proficiency can be obtained for students who have earned 24 hours of college-level credit, with passing grades, at a recognized college/university which is located in an English speaking country and whose language of instruction is English. A waiver of English proficiency can also be obtained for students who have graduated from an English speaking high-school institution, have had 4 units of English at an American High School, or completed grades at an American High School and received a diploma, and for those from West Africa, scored at least a C6 (credit) on the WAEC exam. Step 5 SAT/ACT College Entrance Exams: You must submit exam scores for one of these exams if you are not 21 years or older. You will not be allowed to enroll until you provide us with a copy of your SAT or ACT score. You will be more likely to receive a visa when you visit the embassy if you have an SAT or ACT score.

2 Admission Requirements Step 6 Financial Sponsorship: A student must provide proof of financial support for the period of time necessary to complete degree requirements. Complete the Financial Guarantee Form provided by OPSU by completing the first and second pages. A bank official will complete the bottom portion of the second page and stamp or seal in the marked box. This form must be stamped by your sponsor s bank in order for you to be accepted to OPSU. The financial guarantee must be dated within 6 months of the I-20 issuance and is only valid for one year. Submit a Bank Statement to accompany the Financial Guarantee Form. The bank statement must be original, show the balance of the account, and must be dated within six months of the Form I-20 being issued. Photocopies must be stamped by the bank and sealed in an envelope. OR If your bank is unwilling to complete the previous two requirements, we will accept a Bank Letter. The bank letter should be on bank letterhead, signed and stamped by a bank official, and include the following: 1) Name of account holder If the account is the sponsor s business, the letter should document it and 2) Current account balance in U.S. dollars. Step 7 Step 8 University Health Requirements: Oklahoma state law requires that all new students who attend Oklahoma colleges and universities for the first time provide proof of immunization for certain diseases. You must complete the University Health Requirements form and Compliance form to show you have completed the health requirements. You may complete the Exemption form if you have any objections to receiving the immunizations. You must receive your first dose of MMR (measles, mumps, rubella) and Hepatitis B before admission, unless the Exemption form is completed. A Tuberculosis Skin Test/ t-spot test is required for admission to OPSU, NO EXCEPTIONS. Passport Copy: If you have a passport, you must provide a photocopy. Note: Once students are accepted and arrive at OPSU, they are required to pay full cost for tuition, fees, and housing before they can enroll. School Calendar SPRING Application Deadline October 15 Spring Semester January May FALL Application Deadline June 15 Fall Semester August December Note: All of the required documents must be turned in by the application deadline in order for a student to be accepted.

3 International Application for Admission Oklahoma Panhandle State University PO Box 430, Goodwell, OK If you are a U.S. citizen or U.S. permanent resident alien DO NOT use this application. Please contact High School and Community Relations for an application at or PO Box 430, Goodwell, OK Application deadlines: Fall Session: June 15 Spring Session: October 15 Application For Term (Please circle one and enter year) August/Fall: 200 January/Spring: 200 Personal Information (Please use block letters) Last name/surname: First name/given Name: Other Names under which your records may appear: Passport #: Social Security # (If available): Sex (Please circle one): Male Female Marital Status (Please circle one): Married Single Birth (Month/Day/Year): address: if provided your will be used for correspondence Current Mailing Address/Phone House/Plot #: Street: PO Box: City: State/Province: Zip: Country: Phone Number (Include country code): Permanent Mailing Address/Phone House/Plot #: Street: PO Box: City: State/Province: Zip: Country: Phone Number (Include country code): Parent, Legal Guardian or Next of Kin Address/Phone House/Plot #: Street: PO Box: City: State/Province: Zip: Country: Phone Number (Include country code): Immigration Status Information: Are you a United States Permanent Resident Alien? Yes No If yes, see domestic applicant information Country of Birth: Country of Citizenship: Native (Primary) Language: Do you currently hold non-immigrant status? Yes No If yes, indicate type INS admission number (from Form I-94) If yes submit a copy of your passport, US visa, I-94 card and appropriate INS document (I-20, IAP-66, etc) Do you intend to apply for a change of visa status? Yes No If yes, visa type: Degree/Major Desired Degree at OPSU: Desired Major at OPSU: Desired Minor at OPSU: School Residence Desired On-Campus Housing Off-Campus Housing Commuting (More than 5 miles)

4 Education List ALL secondary schools, colleges and universities you have attended or plan to attend prior to enrollment at OPSU. An official transcript for each institution showing complete coursework must be on file with the Admissions Office before you may be admitted to a degree program and register for a regular semester. If you need more room for information please attach a separate sheet to your application. Name of Institution City/Country Dates Attended (Mo./Yr.) From To Degree(s) Awarded Have you ever been placed on academic probation or suspension at another college? Yes No If yes, please list the name of the institution(s) and dates. Name of Institution Date (Mo./Yr.) Have you ever been placed on disciplinary probation or suspension at another college? Yes No If yes, please list the name of the institution(s) and dates. Name of Institution Date (Mo./Yr.) Have you ever been convicted of a criminal felony? Yes No If yes, please describe: Have you previously applied at OPSU? Yes No If yes, list semester of application: Special Service Would you like to receive information about services for students with disabilities? Yes No Certification I certify that all the information supplied by me in this application is correct and complete, and understand that any misrepresentation or falsification, including failure to report any college or university attendance, is sufficient cause for cancellation of enrollment and/or any credits earned and could result in other disciplinary action. Student Signature: Date: AFFIRMATIVE ACTION COMPLIANCE STATEMENT: This institution, in compliance with Title VI and Title VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 503 and 504 for the Rehabilitation Act of 1973, Section 402 of the Readjustment Assistance Act of 1974, Americans with Disabilities Act of 1990 and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, marital status, disabilities or status as a veteran in any of its policies, practices, or procedures. This includes, but is not limited to admission, employment, financial aid, and educational services.

5 International Student Financial Guarantee All three sections of this form must be completed. This form must be accompanied by a bank statement or bank letter sealed in an envelope by the sponsor s banking institution. Financial sponsorship documents submitted must be original or official received via mail. These documents will not be accepted via fax or . United States Immigration and Naturalization Service (INS) regulations require documentation that sufficient financial resources are available to meet a student s prospective educational and living expenses while in the U.S. Therefore, Oklahoma Panhandle State University requires a guarantee of financial resources from each applicant who expects to obtain or maintain Student (F-1) status. Applicants are required to submit financial documentation that equals or exceeds one full year of expenses, for the program of study they are interested in pursuing. This estimate is based upon 15 lower division credit hours each semester for undergraduate studies. A Certificate of Eligibility (I-20) will not be issued until this information is provided. Scholarships available to international students at OPSU are very limited and students should not rely on scholarship funds or employment to finance their educational costs. Students will not be permitted to enroll without full payment of their expenses upon arrival to OPSU. Please make arrangements in advance for money transfer to the student s OPSU account. Wire transfer instructions can be obtained by ing If bank policies do not allow completion of this form, a separate bank letter or affidavit is an acceptable substitute. The letter should be on bank letterhead and include the following: Name of account holder Signed and stamped or sealed by a bank official Date account was opened Current account balance and date Monetary value must be converted to U.S. dollars Section 1: Applicant and Dependent Information - Immigration documents will not be issued without the applicant s signature. Applying for: Fall 20 Spring 20 Applicant s Last (Family) Name First (Given) Name I understand that by signing below, I will not be permitted to enroll for upcoming semesters until my account balance at OPSU is paid in full. Applicant s Signature Date Dependent One Last (Family) Name First (Given) Name Dependent Two Last (Family) Name First (Given) Name Dependent Three Last (Family) Name First (Given) Name

6 Section 2: Guarantor s Certification Immigration documents will not be issued without the guarantor s signature. Guarantor s Last (Family) Name First (Given) Name Relationship to Applicant Country of Citizenship Permanent Address City State Zip Code Country Circle one: Are you currently residing in the United States? Yes No If you are residing in the U.S., are you a U.S. citizen? Yes No If you are residing in the U.S., are you a Permanent Resident Alien? Yes No If you are residing in the U.S. and are not a U.S. citizen or Permanent Resident Alien, what is your current visa classification? Estimated expenses or cost for study at Oklahoma Panhandle State University for one academic year: Estimated Annual Expenses Tuition Total $11773 Room and Board $6102 Annual School Expenses $17875 Personal Expenses $1575 TOTAL $19450 I understand the expenses listed above are estimates of the average cost. The actual costs may vary based on changes in tuition and fees, books and supplies, room and board, medical insurance premiums and personal life styles. I guarantee that I will provide (Applicant s Name) with sufficient funds to meet the actual expenses incurred, as estimated above, for each year the applicant is enrolled at OPSU. I will provide additional funds necessary to meet the needs of the applicant s dependents. I certify that I can make the necessary arrangements to have all funds transferred to the United States and that I will provide adequate funds for the applicant s travel to and from the U.S. I understand that the total bill is payable before enrollment is permitted for the next semester. Signature of Guarantor Date Section 3: Bank s Certification Immigration documents will not be issued without the bank stamp or seal and bank official s signature. This is to certify that in our opinion, (Guarantor s Name), the guarantor whose signature appears above, has adequate funds to meet the estimated expenses as listed above for the applicant and any dependent s listed for each year that the above named applicant is enrolled at OPSU. This certificate does not constitute a statement of liability on any part or on behalf of the bank incurred by the applicant named above. Bank Stamp/Seal Required Print Name and Title Signature of Bank Official Bank Name and Address Date

7 In Compliance with Oklahoma Statutes, Title Certification of Compliance Hepatitis B, Measles, Mumps and Rubella (MMR) Oklahoma Statutes, Title , requires that all students who enroll as a full-time or part-time student in an Oklahoma public or private postsecondary institution provide documentation of vaccinations against hepatitis B, measles, mumps and rubella (MMR). The statute requires that Institutions notify students of the vaccination requirements and provide students with educational information concerning hepatitis B, measles, mumps and rubella (MMR), including the risks and benefits of the vaccination. The statute permits that when the vaccine is medically contraindicated and a licensed physician has signed a written statement to that effect, such student shall be exempt from the vaccination. Further, the statute permits a student or if the student is a minor, the student's parent or other legal representative, to sign a written waiver stating that the administration of the vaccine conflicts with the student's moral or religious tenets. Student's Name: Institution: Oklahoma Panhandle State University Birth date: Term/Year of first enrollment: Social Security Number or Student ID: 1) I have been notified by my institution of the requirement that I must provide documentation of having received vaccinations against hepatitis B, measles, mumps and rubella (MMR), and 2) I have received and reviewed the educational information provided by my institution concerning hepatitis B, measles, mumps and rubella (MMR), including the risks and benefits of the vaccination, and 3) Further, I certify that: (Place a check in the applicable space, below.) I have been vaccinated and have provided documentation in support as required by Oklahoma Statute, Title , or I have not received the required vaccines, but will begin administration of the vaccines upon enrollment. The administration of the vaccine conflicts with my moral or religious tenets. I have completed the corresponding exemption form to support my objections. Signature: Date: When student is under 18 years of age, the following must be completed: As the parent or other legal representative, I certify that the student named above is a minor and the above information is correct. Signature: Date:

8 UNIVERSITY HEALTH RequiRements First Name Last Name Official Notice: Immunization Requirements for Oklahoma Panhandle State University Students Oklahoma state law requires that all new students who attend Oklahoma colleges and universities for the first time provide proof of immunization for certain diseases. If you cannot verify your immunizations you will need to be re-immunized. ALL NEW STUDENTS MUST COMPLETE THIS FORM. TO BE COMPLETED AND SIGNED BY YOUR HEALTH CARE PROVIDER OR ATTACH COPIES OF RECORDS. ALL INFORMATION MUST BE IN ENGLISH. REQUIRED IMMUNIZATIONS Vaccine Enter date each immunization was given Measles, Mumps, Rubella (Month, Day, Year) Dose 1 Dose 2 Measles, mumps, and rubella (MMR) vaccine is not required for college students born before January First MMR must have been given no earlier than 4 days before the first birthday. The 2 nd dose of measles, mumps, and rubella vaccine must have been administered at least 28 calendar days after the 1 st dose. Written evidence of laboratory tests showing range of immunity to measles, mumps, and rubella is acceptable. Attach written proof to the Certificate. Hepatitis B (Month, Day, Year) Dose 1 Dose 2 Dose 3 Minimum of first 2 shots by 6 th week of class; completion of series by 4 th week of the student s second semester Tuberculosis (Mantoux) Test (Month, Day, Year) Date given Date read Reaction (in millimeters): Neg Pos If positive, chest x-ray: normal abnormal Date: RECOMMENDED IMMUNIZATIONS Hepatitis A (Month, Day, Year) Dose 1 Dose 2 Polio OPV/IPV Dose 1 Tetanus-Diphtheria DTaP or DTP and booster with Td Dose 1 Dose 2 Dose 3 Dose 4 (Td booster) Meningococcal Quadrivalent polysaccharide vaccine Dose 1 * Specific information regarding immunization for meningitis: Oklahoma Law requires that all new students living in campus housing be provided information regarding meningococcal disease and the availability of a vaccine that may prevent meningitis. This information will be sent from OPSU Residential Life. As part of the housing contract, the student, (or parent in the case of a minor), will attest that he/she has either received the vaccine or chosen not to be immunized against meningitis. No additional documentation of this vaccination is required. This is part of the housing contract. To the best of my knowledge, the person above has received the above immunizations Signed Title Date {Physician, nurse or school authority- Do not sign unless minimum requirement for MMR - measles, mumps and rubella - and Hepatitis B are met} Place Stamp/Seal Below 1

9 Request for Exemption MMR and/or Hepatitis B TYPE OF EXEMPTION 1. MEDICAL CONTRAINDICTION: I hereby certify that the immunization(s) specified below are medically contraindicated for named student. Immunization(s) Immunization(s) Specify Contraindications Signature of physician 2. RELIGIOUS OBJECTION: I hereby certify that immunization is contrary to the teachings of the above named student s religion. Signature of student or parent if student is a minor Date 3. PERSONAL OBJECTION: I hereby certify that immunization is contrary to my beliefs. I request an exemption to the immunization requirements for Oklahoma colleges and universities. I have written a brief summary of my objections in the space provided below. Briefly summarize your objections in this space: 4. Please check which immunizations this exemption applies to: [ ] MMR (Measles, Mumps and Rubella) [ ] Hepatitis B [ ] Polio [ ] DtaP/TD (Diptheria, Tetanus & Pertusis) [ ] Meningitis (for students living in Residence Halls Only) [ ] All AUTHORIZATION FOR MEDICAL TREATMENT For All Students: By signature, I verify that the information on this form is accurate and true. By signature I give permission for diagnosis, therapeutic, and operative procedures as may be deemed necessary for me. I understand that lost records are not grounds for an exemption. I also understand that in the event of a disease outbreak at the college I may have to be excluded for my protection and for the protection of other students at the college. Signature Printed Name Date For all students under 18 years of age: I authorize the OPSU to administer medical and surgical services, immunizations and therapeutic procedures as deemed necessary by duly licensed personnel. Parent's or Guardian's Signature Relationship Date 2

10 INTERNATIONAL STUDENTS Estimated cost per semester Oklahoma Panhandle State University PO Box 430 Goodwell OK TUITION AND FEES Per Credit Hour 15 Credit Hours Resident Tuition $ $1, Out-of-State Tuition $ $2, General Fees $79.00 $ Book Rental** $8.00 $ Academic Fee $20.00 $ Semester Fees $62.00 International Fee $15.00 ESTIMATED TOTAL TUITION AND FEES*** $6, **most books will be rentals; however, some classes require you to buy books ***some classes have special instruction fees which are not calculated in the above figures STUDENT APARTMENTS Rent per semester $1, ***There is a $20 nonrefundable application fee and $150 deposit due with contract. DORM Single room per semeste $ Double room per semester $ ***There is a $20 nonrefundable application fee and $100 dorm deposit with contract. MEAL PLAN OPTIONS 10 meals per week per semester $1, meals per week per semester $1, meals per week per semester $1, ***Meal plan is optional for apartment but 10 or higher plan is required for dorms. Estimated Total Cost Per Semester: Tuition and fees (based on 15 credit hours) $6, Dorm Semi-Private $ Meals (based on 20 meal plan $1, TOTAL $8, Rates are subject to change!! Students must also remember that this list does not include personal spending money, or emergency funding. This is only an estimate of your total costs.

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