INTERNATIONAL STUDENT APPLICATION FOR ADMISSION ARKANSAS TECH UNIVERSITY

Office of International and Multicultural Student Services

1) Full Legal Name (as it appears on your passport)

_______________________________________ ____________________________________ _______________________________

(Family or Surname) (First Name) (Middle Name)

2) Permanent Foreign Address

(Street Address or Post Office Box Number) ________________ (Postal Code)

__________________________________________________________

___________________ (Country)

(City)

___________________________

___________________
(State/Province)

____________________________________ _____________________________________________________ (Telephone include country code) (E-mail Address)

3) Mailing Address

________________________________________________________
(Street Address or Post Office Box Number)

________________ (Postal Code)

___________________ (Country)

____________________________________ (Telephone include country code)

(City)

__________________________

(State/Province)

__________________

4) Next of Kin (Mother-Father-Spouse-Guardian)

_____________________________________
(Street Address or Post Office Box Number)

(Family or Surname) (First Name) __________________________________________________________

___________________________________
(City)

_____________________________
(Relationship to you)

(State/Province)

___________________________

___________________

5) Date of Birth

Month _______ Day ______ Year _______

6) Gender*

7) Ethnic Category* (family descent)

____ Not Hispanic or Latino ____ Hispanic or Latino

____ Male

Female ____

*Voluntary information to be used in a nondiscriminatory manner consistent with applicable civil rights laws for reporting and statistical purposes only and cannot affect your eligibility for admission.

8) This application is for:

____ Spring (January) ____ Summer I (June) ____ Summer II (July) ____ Fall (August) of year ___________

9) Should I be admitted, I request that my admission documents be sent:

____ Standard Mail (No additional charge)

10) Educational Objective:

____ English Language Institute

(Intended to improve language proficiency, not interested in enrolling in college coursework at Tech)

____ Express Service via DHL, UPS, Priority Mail or FedEx (Please send an additional $75 (USD) check or money order for this service)

____ English Language Institute, with Undergraduate Admission

(Non-native English speakers without a passing TOEFL/IELTS/EIKEN score with plans to obtain an undergraduate degree)

____ English Language Institute, with Graduate Admission (Non-native English speakers without a passing TOEFL/IELTS/EIKEN score with plans to obtain a graduate degree) ____ Undergraduate Student ____ Graduate Student

11) Intended Major/Field of Study________________________________________________________________________

Bachelors Degree: Undergraduate Students

College of Business
Accounting (BSBA) Business Education (BS) Economics and Finance (BSBA) Management and Marketing (BSBA)

College of Applied Science

College of Education
Early Childhood Education (AS and BS) Middle Level Education English Language Arts/Social Sciences (BS) Middle Level Education Math/Science (BS) Health and Physical Education Teacher Licensure (BS) Health and Physical Education Wellness Fitness (BS)

College of Arts and Humanities

Art Education (BA) Art, Fine Art (BA) Art, Graphic Design (BA) Creative Writing (BFA) Creative Writing Education (BFA) Criminal Justice (AA) English (BA) English Education (BA) Foreign Languages (French, German, Spanish) (BA) Foreign Languages Education (French, German, Spanish) (BA) History (BA) International Studies (BA) Journalism, Broadcast (BA) Journalism, Public Relations (BA) Journalism, Print (BA) Music (BA) Music Education Instrumental (BME) Music Education Keyboard Instrumental (BME) Music Education Keyboard Vocal (BME) Music Education Vocal (BME) Political Science (BA) Psychology (BA) Rehabilitation Science (BA) Social Studies Education (BA) Sociology (BA) Spanish Medical Interpretation (BA) Speech, Communications (BA) Speech, Theatre (BA) Speech Education (BA)

Agriculture Business (BPS-PS-AB) Animal Science (BS) Computer Engineering (BSEE) Computer Science (BS) Culinary Management (AAS) Electrical Engineering (BSEE) Emergency Administration and Management (BS) Horticulture (BS) Information Systems (BS) Information Technology (AAS and BS) Hospitality Administration, Food and Beverage Management (BS) Hospitality Administration, Lodging and Club Management (BS) Hospitality Administration, Tourism and Event Management (BS) Mechanical Engineering (BSME) Nuclear Technology (ASNT) Pest Management (BS) Recreation and Park Administration, Interpretation (BS) Recreation and Park Administration, Natural Resource (BS) Recreation and Park Administration, Turf Management (BS) Recreation and Park Administration, Therapeutic (BS)

Pre-Professional Programs
Pre-Dental Pre-Dental Hygiene Pre-Medical Pre-Law Pre-Pharmacy Pre-Physical Therapy Pre-Veterinary Medicine

Masters Degree: Graduate Students

Master of Liberal Arts (MLA)
Communications Fine Arts Social Sciences

Master of Arts (MA)

English English with Teaching English Second Language (TESL) Option History Multi-Media Journalism Spanish Teaching English to Speakers of Other Languages (TESOL)

Master of Science (MS)

College Student Personnel Emergency Management and Homeland Security Engineering (MSEG) Fisheries and Wildlife Science Health Informatics Information Technology Information Technology, Computer-Based Instructional Technology Nursing: Administration (MSN) Psychology

College of Natural and Health Sciences

Biology (BS) Biochemistry (BS) Chemistry (BS) Chemistry Professional (BS) Engineering Physics (BS) Environmental Biology (BS) Environmental Chemistry (BS) Environmental Geology (BS) Fisheries and Wildlife Biology (BS) Geology Professional (BS) Health Information Management (BS) Mathematics (BS) Mathematics Education (BS) Medical Assistant (AAS) Medical Technology (BS) Nursing (BSN) Physical Science (BS) Physical Science, Nuclear Physics Option (BS) Physical Science, Physics Option (BS) Physical and Earth Science Education (BS-PSED) Life and Earth Science Education (BS-LSED)

12) TEST REPORTS

Please arrange for an official report to be sent from the appropriate testing agency. The institutional code for the TOEFL, SAT and GRE is 6010 and for the ACT is 0114. TOEFL/IELTS/EIKEN scores are not required for ELI applicants. Minimum scores for undergraduate and graduate admission are listed below. Scores must be less than 2 years old.

Undergraduate Students TOEFL 173 (computer) 500 (written) 61 (Internet) IELTS 5.5 or higher EIKEN 2A or higher

Graduate Students TOEFL 213 (computer) 550 (written) 79 (Internet) IELTS 6.5 or higher EIKEN Pre-1or higher

TOEFL/IELTS/EIKEN
Test Date
Month/Year

SAT
Test Date
Month/Year

ACT
Score Test Date
Month/Year

GRE
Score Test Date
Month/Year

Score

Score

13) Citizenship Information (If you have Permanent Residency in the US Green Card stop and go to last page for more instructions.)

Country of Citizenship____________________________

City and Country of Birth_________________________, ____________________________

Passport Number _________________________ Expiration Date____________________ Country Issuing Passport___________________________

14) Is English your native language? Yes ____ No ____ If no, what is your native language? ______________________________________ 15) Will any dependents accompany you? Yes ____
passports:

Arabic

No ____ If Yes, then please list their information below and include a copy of their

___________________________________________________________________________________________________________________________________ Family (Surname) Given Name Date of birth Country of Birth Relationship to you

_________________________________________________________________________________________________________ 16) Current Educational Experience

Are you currently attending a college/ university? Yes ___ No ___ If yes, is this school in the USA? Yes ___ No ___ (If yes, please enclose a copy of your I-20 or Form DS-2019 and visa)

List the courses in progress: _______________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ Will you be receiving a degree? Yes ____ No ____

Type of degree ______________________________________________________________

If you currently attend another college/university state reason for discontinuing: ____________________________________________________ __________________________________________________________________________________________________________________________________

17) Have You Ever Applied/Enrolled at Arkansas Tech University? Yes _____

No _____ If yes, indicate year _________________

18) Previous Education

Location (City/Country) Dates Attended (mm/yy - mm/yy) # Years Attended Type of diploma, certificate or degree received, if any

List in chronological order all the high school/upper secondary and post-secondary schools you have attended.
Name of Secondary School and/or University Attended

High School

To maintain a safe learning community, we ask the following of all applicants. We cannot process your application unless you answer these questions. Answering yes to one or more of the following questions will not necessarily preclude you from being admitted. However, failure to provide complete, accurate, and truthful information will be grounds to deny or withdraw admission, or to dismiss after enrollment.

19) Have you ever been convicted of, or pleaded no contest to, a crime other than a minor traffic violation? Yes ____ No ____ 20) Do you have any criminal charges pending against you? Yes ____ No ____ 21) Have you ever been expelled, dismissed, suspended, or placed on probation by any other school, college or university? Yes ____ No ____ 22) If you have ever served in the military, did you receive any type of discharge other than an honorable discharge? Yes____ No ____
You must promptly notify the IMSSO of any criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than an honorable discharge that occurs at any time after you submit this document. If you do not understand the meaning of a question, please contact the IMSSO for further clarification before answering.

23) Application Fee Payment Information

A non-refundable application fee of $50 is required from each international applicant. Graduate applicants must include an additional graduate application fee of $25. If you would like your I-20 sent by express courier, please add an additional $75 for this service. Please fill out the form below to pay by credit card, or send a check or money order. ____International Student Application Fee ____Graduate School Application Fee $50 $25 ____Express Courier Service Fee TOTAL $75 $___________

Credit Card Type: ____Discover ____Master Card ____VISA Credit Card Number:______________________________________________________________________________________________ Expiration Date (Month/Year):________________________________ Security (CVV/CVC) Code:___________________________

24) Agreement
By signing below, I hereby affirm that all information supplied in this application is complete and accurate. It is my understanding that I shall not be considered for admission to Arkansas Tech University until I have submitted all credentials specified (including application fee(s), official academic records, affidavit of financial support, official language proficiency results, required test scores and a copy of my passport. I understand that withholding information requested or giving false information may make me ineligible for admission and enrollment.

__________________________________________________________________________ ____________________________
Applicants Signature

Date (Month/Day/Year)

Please return completed application to:

International & Multicultural Student Services Arkansas Tech University 1507 North Boulder Ave, Tomlinson Room 29 Russellville, AR 72801 USA

If you have questions, please contact us: Telephone Number: (479) 964-0832 Fax Number: (479) 880-2039 E-mail: imsso@atu.edu Website: http://www.atu.edu/imsso

PLEASE READ THE FOLLOWING INFORMATION BEFORE SENDING APPLICATION FORM Submission Dates Priority consideration will be given to those applications received by May 1 for the fall semester, October 1 for the spring semester, and March 1 for both summer terms. Applications are accepted after these dates. Immunization Requirements Persons born after January 1, 1957 must furnish proof of immunity against measles, mumps, and rubella (MMR) to the ATU Health and Wellness Center prior to enrollment in classes. This includes two immunizations for MMR. All international students are required to have a TB skin test after their arrival to campus. Only tests completed in the U.S. are accepted. Placement Test First-time entering undergraduate degree-seeking students must furnish official ACT or SAT scores to the International and Multicultural Student Services Office prior to enrollment in classes. If ACT or SAT scores are not available prior to enrollment, the student must take the COMPASS exam to determine appropriate English and mathematics course level placement upon arrival. Permanent Residency (Green Card) If you have U.S. Residency (green card), you will not apply for admission through the Office of International and Multicultural Student Services. Undergraduates need to contact the Office of Admissions, Doc Bryan Student Services Building Suite 141, Russellville, AR 72801, or visit their web site at http://admissions.atu.edu/ for an application packet, or by phone at (479) 968-0343. Graduates please contact the Graduate College, Tomlinson 113, Russellville, AR 72801, or visit their web site at http://graduate.atu.edu for an application packet, or by phone at (479) 968-0398. Arkansas Tech University does not discriminate on the basis of color, sex, race, age, national origin, religion, or disability in any of its practices, policies, or procedures. This includes, but is not limited to, admission, employment, financial aid or educational services. Arkansas Tech University complies with all applicable state and federal laws including, but not limited to, Title VI and Title VII of the Civil Rights Act of 1964 as amended, Title IX of the Educational Amendments of 1972, Section 504 of the Rehabilitation Act Amendment of 1974, the Civil Rights Restoration Act of 1987, the American With Disabilities Act of 1990, and the Civil Rights Act of 1991. The Affirmative Action Office, Administration Building, Suite 200, has been designated to coordinate compliance efforts.

2012-2013 International Admission Undergraduate Check List

Undergraduate Students

Official application for international admission $50 application fee payable in US funds

Accepted Methods of Payment 1. Cash (USD Only) 2. Credit Card (Visa, MasterCard or Discover) please include the following information: Credit card number, expiration date, V-Code (3-digit number on the back of the credit card) 3. Money Orders, Cashier Checks or Personal Checks: Please make payable to ATU International and Multicultural Student Services Office ATTENTION! All money orders, cashier checks or personal checks must follow these guidelines or they will not be accepted: 1. Drawn on a US Bank with the banks 9 digit routing number in the lower left corner 2. Denote USD or US Dollars 3. All but personal checks, must be imprinted, NOT handwritten
Submit secondary academic records and a copy of your diploma or leaving certificate. All academic records MUST be originals or certified copies of originals with official English translations. Certified true copies must be certified (both signed and with a seal/stamp affixed) by a registrar, headmaster, or other official at the school where the grades were obtained. Notarized copies will NOT be accepted, because notary publics do not verify the authenticity of the document.

Transcripts

Passing TOEFL/IELTS/EIKEN Score

Students who wish to apply for admission to the English Language Institute (ELI) are not required to demonstrate English proficiency. All other applicants should meet one of the following criteria. A minimum score of 500 on the written TOEFL (Test of English as a Foreign Language), 173 on the computerized TOEFL or 61 on the Internet-based TOEFL. Scores must be received directly from Educational Testing Service (ETS). The school code for Arkansas Tech University is 6010. IELTS (International English Language Testing System) scores are also accepted. A minimum IELTS score of 5.5 or higher must be provided for admission. An EIKEN score of Grade 2A. Scores must be sent directly from STEP, Inc. (Society for Testing English Proficiency). Students may also take any similar test of English proficiency approved by Arkansas Tech University at a site authorized by Arkansas Tech University. Test scores cannot be more than two years old.

Bank Statement of Financial Support

Approximately $20,474 (USD) is needed for one academic year (nine months) of undergraduate study. Certified evidence of the source (specific name of sponsor and relation to student) and amount of financial support must accompany the application. A current financial statement must come directly from the sponsor's financial institution. All bank documentation must be original and cannot be more than six months old. No photocopies are accepted.

Copy of Valid Passport

Transfer Students

Above requirements must be submitted along with the following:

Transfer Applicants with fewer than 24 credit hours must also provide official secondary school academic records. Normally, a maximum of 68 semester hours of acceptable credit may be transferred from community or junior colleges. For full acceptance, transfer credit must average a 2.00 (on a 4.00 scale) or better. Transfer credit is awarded on a course-by-course basis, and final evaluation of transfer credit may not be completed until after the student's arrival on campus. Transfer students are required to submit transcripts to an approved credential evaluation service for a course-by-course evaluation along with written course descriptions in English. Credential evaluation services approved by Arkansas Tech University include:

Educational Credential Evaluators, Inc. (www.ece.org) Global Credential Evaluators, Inc. (www.gcevaluators.com) Global Education Group, Inc. (www.globaledu.com) World Education Services (www.wes.org)

English Proficiency:
Completion of English Composition I and English Composition II from a US College/University with a grade of C or better will be accepted as proof of English proficiency in place of the TOEFL/IELTS/EIKEN.

Copy of your I-94 card Copy of your I-20 or DS-2019 Copy of your visa

2012-2013 International Admission Graduate Check List

Graduate Students

Official application for international students $50 application fee payable in US funds
Accepted Methods of Payment 1. Cash (USD Only) 2. Credit Card (Visa, MasterCard or Discover) please include the following information: Credit card number, expiration date, V-Code (3-digit number on the back of the credit card) 3. Money Orders, Cashier Checks or Personal Checks: Please make payable to ATU International and Multicultural Student Services ATTENTION! All money orders, cashier checks or personal checks must follow these guidelines or they will not be accepted: 1. Drawn on a US Bank with the banks 9 digit routing number in the lower left corner 2. Denote USD or US Dollars 3. All but personal checks, must be imprinted, NOT handwritten

$25 Graduate School fee payable in US funds Same payment details as listed above. Please make money orders, cashier checks or personal checks payable to ATU Graduate College. Transcripts
Submit ALL college, and university academic records. Only four year bachelors degrees are honored: three year bachelor degrees are not honored for admission into the Graduate School. All academic records MUST be originals or certified copies of originals with official English translations. Certified true copies must be certified (both signed and with a seal/stamp affixed) by a registrar, headmaster, or other official at the school where the grades were obtained. Notarized copies will NOT be accepted, because notary publics do not verify the authenticity of the document.

Passing TOEFL/IELTS/EIKEN Score

Students who wish to apply for admission to the English Language Institute (ELI) are not required to demonstrate English proficiency. All other applicants should meet one of the following criteria. A minimum score of 550 on the written TOEFL (Test of English as a Foreign Language), 213 on the computerized TOEFL or 79 on the Internet-based TOEFL. Scores must be received directly from Educational Testing Service (ETS). The school code for Arkansas Tech University is 6010. IELTS (International English Language Testing System) scores are also accepted. A minimum IELTS score of 6.5 or higher must be provided for admission. An EIKEN score of Grade Pre-1. Scores must be sent directly from STEP, Inc. (Society for Testing English Proficiency). Test scores cannot be more than two years old.

Bank Statement of Financial Support

Approximately $16,808 (USD) is needed for one academic year (nine months) of graduate study. Certified evidence of the source (specific name of sponsors and relation to student) and amount of financial support must accompany the application. A current financial statement must come directly from the sponsor's financial institution. All bank documentation must be original and cannot be more than six months old. No photocopies are accepted.

Copy of Valid Passport

Transfer Students
Above requirements must be submitted along with the following:

Final transcript with grades posted from your current college/university Copy of your I-94 card Copy of your I-20 or DS-2019 Copy of your visa