Adrian College International Student Application for Admission Please typewrite or handprint in ink. Please be sure to include your 300-word essay and the International Student Statement of Expenses and Support with your application. Your application will not be reviewed before receipt of these and your offical transcripts and test scores. Send completed application via AIRMAIL to: Adrian College Admissions, Adrian College, 110 S. Madison Street, Adrian, MI 49221-2575, USA
Personal Information Full Name
Mr.
Miss
Mrs.
(Underline family name)
Mailing address as is should appear on envelope
Fax Number Telephone E-Mail Address
Home Address (if different)
Country of Citizenship
Country of Birth
Date of Birth (month / date / year)
Are you married?
If yes, will your spouse accompany you?
Yes
No
Yes
No
(Adrian College does not provide housing for married couples)
If you currently hold a U.S. Visa, indicate type:
Expiration Date:
Family Information Father’s Name Occupation
College Attended
Address (if different than your own) Mother’s Name Occupation
College Attended
Address Guardian’s Name (if appropriate) Address (if different than your own) Family member in the U.S.A.?
Yes
No
Name
Address Educational Objectives I am applying for admission to the:
Fall Semester (beginning in August)
Year
Transfer?
Yes
Spring Semester (Beginning in January)
No
Application deadlines: Fall Semester - May 15 Spring Semester - October 15 What degree do you intend to earn: Bachelor of Arts
Bachelor of Science
Bachelor of Business Administration
Bachelor of Fine Arts
Bachelor of Music
Bachelor of Music Education
What academic fields do you plan to major in? Give the total number of years you expect fo study for your degree
Academic Information Give names of schools attended, locations and dates of attendance. Example: Adrian High School, Adrian, Michigan, U.S.A., 9/02 to 6/06 School Primary Secondary
Location
Month/Year
Month/Year
1.
From
To
2.
From
To
1.
From
To
2.
From
To
Post Secondary
1.
From
To
College or University
2.
From
To
Examinations Secondary School Leaving Certificate Examinations: Were you awarded a certificate of diploma at the conclusion of your secondary studies?
Yes
No
If yes, give certificate / diploma name and date awarded:
Month/Date/Year
Objective Tests taken: TOEFL Score
SAT Score
Date
ACT Score
Date
Date
Adrian College TOEFL Code Number is 1001. Adrian College SAT Code Number is also 1001. SAT and ACT scores are not required, but should be provided if these tests have been taken. Tests you plan to take and test dates: Test
Date
Test
Date
English Language Preparation What languages do you speak at home? How many years have you studied English as an academic subject?
Give Dates: From
To
Place Have you ever attended an ESL program or a school in which English was the primary language of instruction? If yes, please give dates and place:
From
To
Yes
Place
Additional Information From what specific source(s) did you learn about Adrian College? Please give name of publication or individual person. If individual, please mention connection with applicant.
Please list sports and other non-academic activities and interests that you have.
Certification Statement Please sign below to certify that all the information given in this application is true and complete to the best of your knowlege. Signature
Month/Day/Year
Adrian College 110 South Madison Street Adrian, Michigan 49221-2575 1-800-877-2246
No