Undergraduate International Reciprocal Exchange Application

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1 Undergraduate International Reciprocal Exchange Application Oklahoma State University International Students & Scholars 076 Student Union 7013 Phone: Fax: admissions Web: union.okstate.edu/iss/ Enrollment Information Please check each term you will attend OSU. 1. Entry Term: Fall 2009 Spring 2010 Summer Entry Level: Non-Degree Exchange 3. Campus: Stillwater Applicant Information 4. Legal Name: 5. Date of Birth 6. Other Names Used (if applicable): mm/dd/yyyy 7. Permanent Mailing Address: (Should be an international street address for immigration purposes) City State/Province Zip Code Country 8. (Required): 9. Home Phone (Required): 10. Cell Phone: Please include country code Please include country code 11. Birth Place: City: State/Province: Country: 12. Do you plan to live on campus while attending Oklahoma State University? Yes No All freshman under the age of 21 are required to live on campus their first year. For more information on rules and exceptions visit Citizenship Information 13. Country of Citizenship: 14. Non-Immigrants: The immigration status for non-degree students is typically a J1, please specify if you believe you will be attending on a different status. Other (Specify): 1

2 Parent/Guardian/ Next of Kin Information # 1 15a. Name: 15b. Relationship: 15c. 15d. Home Phone: 15e. Cell Phone: 15f. Mailing Address: Parent/Guardian/ Next of Kin Information # 2 City State/Province Zip Code 16a. Name: 16b. Relationship: 16c. 16d. Home Phone: 16e. Cell Phone: 16f. Mailing Address: City State/Province Zip Code Country Additional Applicant Information (Information will not be used in a discriminatory fashion.) 17. Gender: Male Female 18. Marital Status: Married Single Post Secondary/College or University Attending (please indicate where you are currently enrolled) 19. College/City, State & Country Enrolled From (mm/yy) Enrolled To (mm/yy) Additional Applicant Information 20. What is your native language?* English Other *Applicants must answer the above question, or it will result delaying the processing of your application. 21. If English is not your native language, have you taken the TOEFL? Or IELTS? If yes, date(s) taken: (TOEFL Test of English as a Foreign Language, IELTS International Language Testing system) Score(s): 22. Are you a first generation college student in your family? Yes No 23. Do you have a parent or grandparent who received a Bachelor s degree or higher from OSU (Stillwater or Tulsa campus)? Printed full name of parent/grandparent as it was when enrolled in OSU Type of Degree (BA/BS, MA/MS, PhD) 2

3 Judicial Information Failure to answer these questions will delay the processing of your application, and we will be unable to render an admission decision. If your answer to any of these questions is yes, you are required to provide a written explanation of the event. In addition, you are required to enclose copies of all official documentation explaining the final disposition of the proceedings. 24. Have you ever been suspended or expelled from any college or university? Yes No 24a. Was it a result of an academic issue? Yes No 25. Have you ever been convicted of a felony? Yes No All Applicants I understand that this application is for the admission to Oklahoma State University and is valid only for the term indicated in item 1 on page 1. I also understand and agree that I will be bound by the university s regulations concerning application deadline dates and admission requirements. I certify that the information given in this application is complete and accurate, and I understand that to make false or fraudulent statements within this application or residence statement may result in disciplinary action, denial or admission and invalidation of credits or degrees earned. If admitted, I promise to fulfill all financial obligations to institution which I may incur and hereby agree to abide by the policies of the Oklahoma Board of Regents and the rules and regulations of the university. Should any of this information I have given change prior to my enrollment at the university, I shall immediately notify the office of International Students & Scholars. I authorize any high school, university or college I have attended to furnish enrollment and/or grade information as may be requested by Oklahoma State University. All credentials submitted in support of this application become and remain the property of Oklahoma State University. I understand the fee I submit with this application is non-refundable. Applicant s Original Signature (In blue or black Ink) Print Name Date Checklist: Did you remember to? Verify and complete all information on this application. Sign the application. Include a copy of your Passport Forward official secondary school/college transcripts and test scores. Include Financial Guarantee Form MAIL APPLICATION TO: Oklahoma State University Study Abroad/National Student Exchange Office 060 G Student Union

4 Please Call Us If You Have Questions! Study Abroad/National Student Exchange Office 060 G Student Union Phone: Website: English Language Institute 307 Wes Watkins Center Phone: Fax: Website: International Students & Scholars 076 Student Union Phone: Website: Residential Life Iba Hall, 2064 E mail: reslife@okstate.edu Phone: (405) Fax: (405) Website: 4

5 Admission Application Instructions 1. Entry Term: Select as many semesters as needed for the term and complete the year. 2. Entry Level: Select the entry level in which you plan to enroll at OSU.*Students may only enroll in up to 9hours as a non-degree seeking student. 3. Campus: Select a primary campus. Note: Freshman level classes are not currently offered at the Tulsa campus. 4. Legal Name: Applicant s full legal name. 5. Date of Birth: Please enter applicant s date of birth, including day month, and year (mm/dd/yyyy). 6. Other names: Other names under which applicant s record test scores or transcripts may appear (ex: maiden name). 7. Permanent Mailing Address: Must be an international mailing address for immigration purposes/ 8. Applicant s personal address (applicant will receive an OSU address after the application is process). 9. Home Phone: Applicant s home telephone number with area code. 10. Cell Phone: Applicant s cell phone number with area code. 11. Birth Place: The City, State and Country are required for all applicants. If you were not born in Oklahoma you may leave county blank. 12. Select one box. Freshman applicants under the age of 21 are required to live on campus their first year. For more information on rules and exceptions visit www. Reslife.okstate.edu. Questions are to be completed by Non-US Citizens only. 13. Country of Citizenship: Please enter the country in which the applicant holds current citizenship. 14. Non-Immigrants: Select the VISA status acquired while attending OSU. If type is not listed, please enter next to Other. 15. Parent/Guardian Information: Please enter parent/guardian information if applicable including: name, relationship (mother/father/guardian, etc. ) home phone, cell phone, mailing address, time in which parent/guardian has resided at the listed address. 16. Secondary Parent/ Guardian/Next of Kin Information: Please enter second parent/guardian information if applicable including; name, relationship (Mother/father/guardian etc.), , home phone, cell phone, mailing address, time in which parent/guardian has resided at listed address. Questions are requested for reporting purposes and needed for immigration. Information will not be used for discriminatory purposes. 19. Please indicate the post-secondary university or college you are currently attending. 20. If applicant s native language is English, please select the appropriate box. If not, check the box for Other and write the name of applicant s native language in the space provided. 21. If applicant has taken the TOEFL or IELTS exam check the box for Yes and write the date of the last time exam was taken. 22. Please indicate if you are the first person in your family to attend a college or university. 23. List parent/grandparent/guardian/step-parent that obtained a degree from OSU (Stillwater or Tulsa) Applicant must check 1 box for each question. If answer to either question is Yes, please submit a full explanation of the event and a description of the final disposition of proceeding to: International Students & Scholars, 076 Student Union,. All applicants must sign and date the application. 5

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