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Education That Works International Student APPLICATION FOR ADMISSION We are pleased that you are considering Clackamas Community College and are happy to provide you with our International Student admission materials. This information should give you the basics you need for admission to CCC. You can also visit us on the web at www.clackamas.edu/ international. Frequently Asked Questions: When do I apply? We encourage you to apply at least one term prior to the term you plan to begin your studies. Filing deadlines can be found on our website at www.clackamas.edu/ international: What if I am a transfer student from another school or university in the United States? You will be required to provide a completed International Student Transfer form. Can I be enrolled part-time?, all international students are required to maintain a full course of study (12 credits). Students admitted to the Program for International English must maintain a minimum of 18 class hours per week. Does CCC provide housing? We do not provide on-campus housing. However, a list of local housing options is available by visiting www.clackamas.edu/international. Who can I contact if I have questions or need assistance? Enrollment Services Specialist 503-594-6074 international@clackamas.edu Page 1 of 6 Application Checklist Required Items The following documents are required for admission. All items listed below must be received by Enrollment Services prior to reviewing your application and the issuing of an I-20. Completed CCC Application for Admission $50.00 processing fee (please include an additional $65 to have your I-20 sent to you by express mail) This can be done by clicking on the Pay w with Peer- Transfer button on the International Students web site Official financial documents proving sufficient funds to cover all expenses associated with the proposed program of study. Additional details are available on page 4. Official transcripts from all prior U.S. post-secondary colleges or universities attended Proof of completion of high school or your home country s equivalent program Submit proof of English language proficiency by one of the following: TOEFL score of a 61 ibt or higher IELTS score of 6.0 or higher Completion of 2 college level (100 or above) courses in composition or writing with a grade of C or better, taken at a US post-secondary college or university Verification of Health Insurance form International Student Transfer Form (only if you are transferring from a school within the U.S.) Copy of Passport Participation in a college level course of study is not guaranteed by meeting the above minimum requirements. To be admitted into college level courses, a student must also achieve a placement test score of 70+ on the CCC writing placement test. If you are unable to demonstrate English proficiency at the required level, you will be placed in the Program for Intensive English (PIE) and conditionally admitted to college level courses of study. Please forward all admission materials to: Enrollment Services/Roger Rook Hall Clackamas Community College 19600 Molalla Avenue Oregon City, Oregon 97045-7998 Additional information and forms can be obtained by going to our website at: www.clackamas.edu/international.

CCC International Student Application for Admission Personal Information Term you plan to begin: Summer (June), 20 Fall (September), 20 Winter (January), 20 Spring (April), 20 What is your educational goal at CCC? Program for Intensive English 2 year degree program Intended major area of study (see page 6): Name (as printed in passport): Last/Family Name First Name Middle Name Email Address (required) Current Telephone Number Country of Citizenship Country of Birth Date of Birth (mm/dd/yyyy) Legal Sex Male Female Other/Unknown Marital Status: Married Single Will dependents accompany you to the U.S.? (list family members below) Family Name First Name Middle Name Birthdate Country of Birth Male Female Relationship Family Name First Name Middle Name Birthdate Country of Birth Male Female Relationship Family Name First Name Middle Name Birthdate Country of Birth Male Female Relationship U.S. Mailing Address (address within the U.S. if you have one) Address Number and Street Apt # City State Zip or Postal Code Telephone Number Email Address (required) Home Country Mailing Address (required) Address Number and Street Apt # City State/Province Postal Code Country Telephone Number Email Address (required) Page 2 of 6

Are you currently residing in the U.S.? If yes, what is your immigration status? F-1 Other Where would you like your I-20 & acceptance packet sent? Home country mailing address U.S. mailing address Agency address Will be picked up by (name and relationship to you) Person to be notified in case of an emergency (either in the U.S. or abroad): Name Relationship to you Address Telephone number Email Education If you are currently studying at a school in the U.S., do you plan to leave the U.S. before starting your program at CCC? List all previous secondary/high schools, colleges, universities, and ESL programs attended. Name of School Location Dates attended Graduated? When? From Until Verification of Application Information I understand that if I am admitted to Clackamas Community College as an International Student, I must complete 12 or more credits (or 18 class hours each week if admitted to PIE) and maintain a minimum GPA of 2.0 each term in order to meet satisfactory academic progress and remain in status with the U.S. Department of Homeland Security. I also certify that the information on this application form is true and accurate. Signature Date Name (please print) Page 3 of 6

Statement of Financial Responsibility International Student educational expenses for the 2018-2019 academic year: Academic Year (9 months) One Term (3 months) Tuition and Fees* $10,500.00 $3,500.00 Books and Supplies $2,100.00 $700.00 Living Expenses** $12,000.00 $4,000.00 Total Cost $24,600.00 $8,200.00 *Tuition subject to change **Estimated expenses, actual expenses may vary Current (dated within the last 90 days) official financial documents must accompany this form and be received by Enrollment Services as part of your application. In accordance with DHS regulations, Clackamas Community College cannot offer admission or issue an I-20 until you have provided evidence that you have adequate funds for your proposed program of study. The estimated cost of attending at CCC for one academic year (9 month budget) for 2018-2019 is $24,600.00 plus an additional $8,000.00 if you have a spouse and/or $4,000.00 for each child. Important!! 1. DHS restricts student employment. You should not expect to supplement your income with employment during your program of study at CCC. 2. Please keep copies of this form and your financial documents to present at the U.S. Consulate for your visa interview and to the U.S. Immigration officers at your port of entry. 1. Please list and document the amount and source of your financial support during your program of study: Source of Funding Submit Required Documents Amount of Support Personal Funds Official bank letter reflecting current balance of $ account, name of account holder and date Sponsor Same as above plus the completed statement of $ financial support shown below Salary while on leave Official validated letter from employer outside $ the United States Government or sponsoring agency Official copy of award letter $ Total Funds Available: (Must equal the estimated cost of attending as stated above) $ NOTE: The Financial Support Document must reflect funds available in US dollars and meet the minimum amount of $24,600. Statement of Financial Support Name of Sponsor Name of Student Relationship to Student Address of Sponsor Telephone Email I hereby certify that I am able and promise to pay the estimated cost of attending CCC as stated above. Expenses for tuition, fees, books/supplies and cost of living are payable in U.S. dollars. Documentation of financial resources in the form of an official bank letter and/or validated award letter accompanies this affidavit of support. Signature of Sponsor Date Page 4 of 6

2. Complete the Certification of Information provided I certify that all statements on this Statement of Financial Support and Affidavit of Support are true and accurate. All copies of documents that I have provided are unaltered and reflect true copies of originals. I understand that admission to or enrollment at Clackamas Community College may be denied if any information that I have provided is found to be false. I agree to notify CCC of any changes in my financial circumstances. Applicant Signature (required) Date 3. Provide a Release of Information to a Third Party or Sponsor I authorize the release of any information submitted by me in connection with my CCC application for admission to any person, firm, corporation, association or government agency for the purposes of explanation or verification. Enter Third Party or Sponsor information below. Applicant Signature (required) Date Verification of Health Insurance CCC requires you to purchase student accident and health insurance through the school unless you can verify the following: You are currently insured under a similar insurance policy that is effective in the United States. Your insurance coverage is now in effect and will continue to be in effect throughout your course of study at CCC. Please include a copy of your insurance card. If you have accident and health insurance as indicated above, please provide the following: Name of insurance company Address of insurance company Policy number Effective date of coverage Expiration date of coverage I hereby certify that the answers and information provided above are true, complete and correct to the best of my knowledge. Student Name (please print) Student signature Date I currently do not have health and accident insurance but will purchase it upon arrial in the U.S. Student Name (please print) Student signature Date Admission Policy Statement Clackamas Community College is approved by the U.S. Department of Homeland Security (DHS) to admit qualified students from other countries. International students may be admitted to the college if they can demonstrate proficiency in English and have the financial ability to pursue a full course of study in the United States. International students are required to maintain a minimum 2.0 GPA and complete at least 12 credits each term. Program for Intensive English Students are also required to maintain a 2.0 GPA and complete a minimum of 18 weekly class hours each term. Page 5 of 6

CCC Program Options Accounting & Administrative AAS Accounting AAS Administrative Office Professional ASOT Emphasis in Business CC Accounting Clerk CC Administrative Office Assistant CC Administrative Office Assistant Training Arts & Media AAS Digital Media Communications AAS Music Performance & Technology AAS Web Design and Development AS Emphasis in English (Marylhurst University) AS Emphasis in English (OSU) AS Emphasis in English (PSU) AS Emphasis in English (UO) AS Emphasis in Music (PSU) CC Entry Level Multimedia Journalist CC Music Technology CC Video Production Technology CC Web Design Automotive & Transportation AAS Auto Body Collision Repair & Refinishing Technology AAS Automotive Service Technology CC Auto Body Collision Repair & Refinishing Technology CC Auto Body Specialist CC Collision Refinishing Specialist CC Collision Repair/Refinishing CC Professional Truck Driver CC Under Car Technician-Automatic Transmission CC Under Car Technician-Manual Transmission CC Under Hood Technician Business AAS Business AAS Project Management ASOT Emphasis in Business CC Business Management CC First-Line Supervisor Fundamentals CC Human Resource Management CC Human Resource Management Essentials CC Integrated Marketing & Promotion CC Management Fundamentals CC Marketing CC Project Management CC Project Management Leadership & Communication CC Project Management Tools & Techniques CC Retail Management CC Retail Management Expanded Computer Science AAS Computer & Network Administration AAS Computer Application Support AAS Web Design and Development AS Emphasis in Computer Science (Portland State University ASOT Emphasis in Computer Science CC Computer & Network Administration CC Computer Application Support CC Web Design Education & Human Services AAS Early Childhood Educ. & Family Studies AAS Emergency Management AAS Human Services Generalist CC Alcohol & Drug Counselor CC Early Childhood Education & Family Studies CC Gerontology CC Gerontology for Healthcare Professionals CC Human Services Generalist CC Nursing Assistant-Gerontology Specialist CC Paraeducator Exploratory/Other If you re unsure of the area of study you d like to pursue, select either the (ideal for transferring to a university) or the (ideal for not transferring/two years or less) College credit, but not seeking degree/certificate Community Education English as a Second Language GED/Adult High School Diploma High school student taking classes at CCC Workshops (career-related) Health Sciences AS Emphasis in Biology (OSU) AS Emphasis in Biology (PSU) AS Emphasis in Biology (UO) CC Emergency Medical Technology CC Fitness Technology CC Gerontology CC Gerontology for Healthcare Professionals CC Nursing Assistant-Gerontology Specialist Pre-Clinical Lab Assistant Pre-Dental Assistant Pre-Medical Assistant Pre-Nursing Humanities & Social Sciences AS Emphasis in English (Marylhurst University) AS Emphasis in English (OSU) AS Emphasis in English (PSU) AS Emphasis in English (UO) Industrial Technology AAS Computer-Aided Manufacturing AAS Electronics Engineering Technology AAS Manufacturing Technology AAS Microelectronics Systems Technology AAS Welding Technology AS Emphasis in Construc. Eng. Mgmt. (OSU) CC CNC Machining Technician CC Electronics Engineering Technology CC Entry Level Welding Technician CC Manufacturing Technology CC Mastercam CC Microelectronics Systems Technology CC Welding Technology Natural Resources AAS Horticulture AAS Landscape Management AAS Landscape Management: Arboriculture AAS Renewable Energy Technology AAS Water and Environmental Technology AS Emphasis in Geology (PSU) AS Emphasis in Horticulture (OSU) CC Energy Systems Maintenance Technician CC Geographic Info. Systems Technology CC High Purity Water CC Horticulture CC Irrigation Technician CC Landscape Practices CC Organic Farming CC Plant Health Management CC Renewable Energy Technology CC Water and Environmental Technology Public Safety & Service AAS Corrections AAS Criminal Justice CC Fire Science Wildland CC Juvenile Corrections CC Wildland Fire Fighter 1 CC Wildland Fire Forestry Science & Engineering AS Emphasis in Biology (OSU) AS Emphasis in Biology (PSU) AS Emphasis in Biology (UO) AS Emphasis in Biol. Engineering (OSU) AS Emphasis in Chem. Engineering (OSU) AS Emphasis in Civil Engineering (OSU) AS Emphasis in Civil Engineering (PSU) AS Emphasis in Comp. Engineering (PSU) AS Emphasis in Computer Science (PSU) AS Emphasis in Construction Engineering Management (OSU) AS Emphasis in Ecol. Engineering (OSU) AS Emphasis in Electrical Engineering (OSU) AS Emphasis in Energy Systems Engineering (OSU) AS Emphasis in Engineering (George Fox University) AS Emphasis in Engineering (OIT) AS Emphasis in Engineering (OSU) AS Emphasis in Env. Engineering (OSU) AS Emphasis in Env. Engineering (PSU) AS Emphasis in Geology (PSU) AS Emphasis in Industrial/Manufacturing Engineering (OSU) AS Emphasis in Mech. Engineering (OSU) CC Geographic Info. Systems Technology $ KEY AAS AOS ASOT CC OIT OSU PSU UO Associate of Arts Oregon Transfer Associate of Applied Science Associate of Science Associate of Science Oregon Transfer Certificate of Completion Oregon Institute of Technology Oregon State University Portland State Oregon University of Oregon Return completed form to: Email: international@clackamas.edu FAX: 503-722-5864 IN PERSON: Enrollment Services, Roger Rook Hall Lobby MAIL: Enrollment Services, Clackamas Community College, 19600 Molalla Ave, Page 6 of 6 Revised 4/4/18