International Student Application

About You

First Name

Last Name

Age

Date of Birth

Mailing Address

City

Province:

Home Country:

Postal Code:

Permanent Address:

City:

Province:

Home Country:

Postal Code:

Birth Country:

Country of citizenship:

Phone:

Cell Phone:

Email:

What is the best way to Contact you?

Status

Single Married

Number of children:

Which program are you interested in?

Radio TV/Video Production

Where did you hear about The Academy?

Education-----

High School Attended

Date of Graduation

Date GED Attained

College/University Attended

Years Attended

Field of Study

Date of Graduation

Degree Attained

Other Schools Attended

Type of Training

Visa Information-----

Do You Currently Have A U.S. Visa?

Yes No

Are You Currently In The U.S.?

Yes No

Date Visa Expires:

Month:

Year:

Will You Be Applying For Change of Status?

Yes No

Are You Currently Attending School in the US With An I20?

Yes No

If yes, please give your school’s information:

School Name:

Address:

City:

State