Student Identification Form
This form is to be attached to any document you send in support of your application for admission. Make as many copies as you need.
______Full name (family name, first name, middle name) as it appears on your application for admission.
______Date of Birth (month, date, year)
______Electronic Application ID Number
______Student ID Number ( if known) or Social Security Number
Intended Major
Level of Study ( Undergraduate / Graduate )
Return this form to the University of Houston Office of Admissions 4400 University Drive Houston, Texas 77204-2023 U.S.A. NAME: ID NUMBER: LAST FIRST MIDDLE
SECTION E STATEMENT OF UNDERSTANDING (Graduate) Important: You must return this statement with your completed admission application. Instructions: Read the statements below carefully. You must agree to each of these statements before you will be considered for admission. 1. I understand that if English is not my native language,1 I must take the Test of English as a Foreign Language (TOEFL). 2. I understand that if I am admitted to the university, I may be tested again for my English proficiency prior to registration at the university. On the basis of these scores, I understand I will be placed in the appropriate English courses for international students. 3. I understand that I must make my own arrangements for housing. (To reserve a room in a University of Houston dormitory, I must apply to the director of housing several months before the semester begins.) 4. I have read and understand all admission procedures. I understand that all documents and materials relating to my admission should be forwarded to the Office of Admissions. I also understand that the $75 U.S. application fee is not refundable and that my application will not be processed without the fee. 5. I understand that I must give written permission to the University of Houston for anyone other than myself to request information about the status of my application and/or admission status. 6. I understand that if I am unable to attend the University of Houston for the semester in which I am approved, a written request and an additional application fee may be required in order to update my file. 7. I understand that I must submit an official, translated syllabus or course description of all course work taken at a foreign university or college by the application deadline in order to insure a transfer evaluation during my first enrolled semester. 8. I understand that I must arrive in time to attend the one-week orientation for nonimmigrant international students; the cost of the orientation is $50 U.S. 9. I understand that I must pay the international student insurance fee for medical/hospitalization coverage. Exemptions are made only for those with proof of a currently valid policy showing a minimum of $50,000 U.S. coverage, including insurance for repatriation and medical evacuation. 10. I understand that I should have $19,350 U.S. available for my first year of study. This amount includes living expenses for 12 months. If attending summer school, add $4,000 for summer tuition. Of this amount, I must have a minimum of $6,000 U.S. in my possession to meet initial expenses when I arrive in Houston. I am advised to carry this in the form of traveler’s checks. These figures are subject to change with out notification. 11. I understand that I must accept visa restrictions which prohibit off-campus employment. 12. I understand that I should arrive in Houston on or before the date specified on the I-20 form or DS-2019. If I cannot arrive on time, I must request in writing that my application be considered for a subsequent semester and I may be requested to pay an additional fee. 13. I understand that I must allow a minimum five weeks processing time. 14. I understand that the University of Houston may release a portion or all of my record to any of the UH campuses. 15. I understand if I do not attend, the University of Houston will maintain my documents for one academic year. 16. I understand that all of my documents become the property of the University of Houston. If you agree to fulfill all the requirements as stated above, please sign below.
Signature of Applicant
Date
1Students from Australia, the Bahamas, Belize, the British Isles, English-speaking Canadian provinces, the Fiji Islands, Jamaica, Liberia, New Zealand, Sierra Leone, South Africa, Trinidad, the United States, the Virgin Islands, the West Indies and Zimbabwe are exempt from taking the TOEFL with exceptions as listed under the English Proficiency Requirements. U.S. high school graduates must take the SAT or ACT test. Undergraduate students who have successfully completed Level 6 of the University of Houston Language and Cultural Center are exempt from taking the TOEFL. NAME: ID NUMBER: LAST FIRST MIDDLE
SECTION F LETTER OF FINANCIAL BACKING This form must be updated every six months. The Affidavit of Support form (I-134) is valid for one year from the signature date. The University of Houston requires confirmation of financial resources for applicants who hold an F or J visa. This statement must be completed and on file with the university prior to the release of immigration documents. Please print all information. The University of Houston reserves the right to request bank statements as supporting documentation. (NOTE: If self-sponsoring, you must include a recent bank statement showing assets of the $19,3501 amount times the number of years you will be attending.) This is to certify that I will assume full financial responsibility (a minimum of $19,3501 U.S. per year) for the support of
Name of Student attending the University of Houston Social Security number or UH Identification Number
Country of Birth Date of Birth
Country of Citizenship
Sponsor’s Signature 2 Date
Sponsor’s Full Name
Sponsor’s Relationship to Student
Sponsor’s Address
Telephone
1These figures are subject to change without notification. This amount includes living expenses for 12 months. If attending summer school, add $4,000 for summer tuition.
2 To be signed by the student only when self-sponsoring. This information is necessary for the Certificate of Eligibility (I-20 form) or DS-2019.
DEPENDENT INFORMATION
If you are seeking entry for your dependent(s); i.e., spouse and children, you must provide us with the following information. Financial proof of $1,500 is required for each dependent.
Family Name
First Name
Date of Birth
Country of Birth
Relationship to F-1 Student An overseas address is required for each dependent if different from the F-1 student.
Street
Street
Street
City/Province
State
ZIP Code
Country NAME: ID NUMBER: LAST FIRST MIDDLE
SECTION G
PERMISSION RELEASE In order to protect your privacy rights, the Office of International Admissions requires that all students give written permission specifying the person who may have access to the information concerning the status of his or her application and/or admission to the University of Houston. If you wish to designate someone access to this information, please complete the information below:
I, , give (print your name) (print name of friend or relative) permission to request information concerning the status of my application and/or admission status to the University of Houston. I further give permission to the University of Houston to release this information to this person upon request. I understand that the above named person(s) may be required to show proof of picture identification when requesting information in person. I also understand that if the information is requested by telephone by this person, complete information as to my 1) full name, 2) student number, 3) date of birth and 4) complete address must be stated in order for any information to be released from our office to the designated person.1
(your signature)
(your student number)
(date)
1Confidentiality rights are not applicable to telephone inquiries.
ETHNIC BACKGROUND
Please indicate which of the following groups best describes your ethnic background. This information is voluntary and will be used in a nondiscriminatory manner, consistent with applicable civil rights laws. This information will be used for federal and/or state law reporting purposes only and will not be used in any admission or scholarship decisions. ❑ American Indian/Alaskan Native ❑ African American/Black ❑ Asian/Pacific Islander ❑ Hispanic/Latino ❑ White/Non-Hispanic ME: ID NUMBER: LAST FIRST MIDDLE
SECTION H—DEGREE CLARIFICATION FORM, PA RT I HIS PAGE MUST BE RETURNED WITH THE APPLICATION. Please mark any of the following that best describe degrees that you have or ill have completed prior to applying to the University of Houston. Please also indicate the country where degree(s) was(were) earned. Length of Full-time Length of Full-time Study (in years) Study (in years) me of Degree Required for Degree† Country Name Name of Degree Required for Degree† Country Name xample: India ✓Bachelor of Arts 4 (BA) 004 Degree Objective Doctoral (DEG DR) 601
Bachelor of Arts (BA) 004 Degree Objective Master (DEG MS) 501
Bachelor of Arts ++ (BA2) 017 Degree Objective Undergraduate (DEG UN) 001
Bachelor of Arts ++ (BA2) 017 Diplom (DIPLOM) 126
Bachelor of Arts +++ (BA3) 020 Diplom * (DIPLOMB) 162
Bachelor of Arts ++++ (BA4) 021 Diplom ** (DIPLOMQ) 762
Bachelor Degree ** (BACHELOQ) 180 Diplom *** (DIPLOMM) 562
Bachelor Degree (Bachelor only) (BACHELOR) 123 Diplom **** (DIPLOMD) 662
Bachelor of Accountancy (BACY) 002 Diplom-Ingenieur * (DIP-INGB) 161
Bachelor of Architecture (BARCH) 003 Diplom-Ingenieur ** (DIP-INGQ) 761
Bachelor of Applied Science (BAS) 139 Diplom-Ingenieur *** (DIP-INGM) 561
Bachelor of Business Admin. (BBA) 005 Diplom-Ingenieur **** (DIP-INGD) 661
Bachelor of Behavioral Science (BBEHASCI) 189 Diplom-Ingenieur (DIPIUG) 125
Bachelor in Education (BEDU) 181 Diploma (DIPLOMA) 132
Bachelor in Engineering (BENGI) 182 Diploma * (DIPLOMAB) 163
Bachelor in Environ. Design (BENVDESI) 187 Diploma ** (DIPLOMAQ) 763
Bachelor of Fine Arts (BFA) 006 Diploma *** (DIPLOMAM) 563
Bachelor of General Studies (BGENSTUD) 183 Diploma **** (DIPLOMAD) 663
Bachelor of Interdisciplinary Sci. (BISCI) 022 Doctor of Musical Arts (DMA) 606
Bachelor of Journalism (BJOUR) 186 Doctor (DOCTOR) 128
Bachelor of Liberal Studies (BLIBESTU) 188 Doctor of Education (EDD) 602
Bachelor of Music (BM) 007 Foreign Certificate (FORCERT) 122
Bachelor of Music Education (BMED) 026 Doctor of Jurisprudence (JD) 603
Bachelor of Science (BS) 008 Kandidat Nauk * (KANDIDAB) 165
Bachelor of Science (second deg.) (BS2) 018 Kandidat Nauk ** (KANDIDAQ) 765
Bachelor of Science in Civil Eng. (BSCE) 010 Kandidat Nauk *** KANDIDAM) 565
Bachelor of Science in Chem. Eng (BSCHE) 009 Kandidat Nauk **** (KANDIDAD) 665
Bachelor of Science in Education (BSED) 011 Kandidat Nauk (KANDNAUK) 133
Bachelor of Science in Elec. Eng. (BSEE) 012 Licenciado (LICENCI) 127
Bachelor of Science in Elec. Tech. (BSELE) 185 Licenciado * (LICENCIB) 166
Bachelor of Science in Geology (BSGEO) 134 Licenciado ** (LICENCIQ) 766
Bachelor of Science in Indust. Eng (BSIE) 013 Licenciado *** (LICENCIM) 566
Bachelor of Science in Mech. Eng. (BSME) 014 Licenciado **** (LICENCID) 666
Bachelor of Social Work (BSOCWRK) 184 Bachelor of Laws (LLB) 136 FOR OFFICE USE ONLY Bachelor of Science in Petrol. Eng. (BSPETE) 138
Bachelor of Science in Pharmacy (BSPHR) 015 * First undergraduate degree Bachelor of Science in Pharmacy++ (BSPHR 2) 025 ** First undergraduate degree plus 30 credit hours or one year of graduate studies Bachelor of Science in Technology (BSTCH) 016 *** First graduate degree
Bachelor of Science in Tech. ++ (BSTECH2) 019 **** Highest graduate degree + First degree Candidatus * (CANDIDAB) 160 ++ Second degree Candidatus ** (CANDIDAQ) 760 +++ Third degree Candidatus *** (CANDIDAM) 560 ++++ Fourth degree
Candidatus **** (CANDIDAD) 660 †12–13 years of primary and secondary are required prior to the figure listed on all of the above. (E.g. Students from Philippines who only completed 10 years of primary and secondary prior to university Candidatus (CANDIDAT) 129 studies, and whose bachelor degree required 4 years to total 14 years of formal education should indicate FOR OFFICE USE ONLY “2” as number of years required fordegree.) ME: ID NUMBER: LAST FIRST MIDDLE
SECTION H—DEGREE CLARIFICATION FORM, PA RT II HIS PAGE MUST BE RETURNED WITH THE APPLICATION. Please mark any of the following that best describe degrees that you have or ill have completed prior to applying to the University of Houston. Please also indicate the country where degree(s) was(were) earned. Length of Full-time Length of Full-time Study (in years) Study (in years) me of Degree Required for Degree† Country Name Name of Degree Required for Degree† Country Name
Master of Laws (LLM) 525 Master of Science in Petro. Eng. (MSPETE) 531
Master of Arts (MA) 502 Master of Science in Pharmacy (MSPHR) 520
Magister Artium (MAGART) 135 Master of Science in Physio. Optics (MSPHYSOP) 521
Magister Artium * (MAGARTB) 167 Master of Science in Physio. Optics (MSPO) 534
Magister Artium ** (MAGARTQ) 767 Master of Science in Systems Eng. (MSSYSE) 532
Magister Artium *** (MAGARTM) 567 Master of Social Work (MSW) 522
Magister Artium **** (MAGARTD) 667 Master of Technology (MTCH) 535
Maitrise (MAITRISE) 130 Non-Degree Objective Doctoral (NDO DR) 600
Maitrise * (MAITRISB) 168 Non-Degree Objective Law (NDO LA) 400
Maitrise ** (MAITRISQ) 768 Non-Degree Objective Master (NDO MS) 500
Maitrise *** (MAITRISM) 568 Non-Degree Objective Undergrad. (NDO UN) 000
Maitrise **** (MAITRISD) 668 Doctor of Optometry (OD) 604
Master of Architecture (MARCH) 523 Post-Bac Grad. Study Prerequisite (PBGSP) 102
Master Degree (MASTER) 124 Post-Bac Personal Enrichment (PBPE) 103
Master of Arts in Teaching (MAT) 582 Post-Bac Second Baccalaureate Deg (PBSBD) 100
Master of Business Admin. MBA) 504 Post-Bac Teacher Certification (PBTC) 101
Master of Civil Engineering (MCE) 512 Doctor of Pharmacy + (PHARM D1) 610
Master of Chemical Engineering (MCHE) 510 Doctor of Pharmacy ++ (PHARM D2) 611
Master of Education (MED) 505 Doctor of Pharmacy +++ (PHARM D3) 612
Master of Education (MEDUC) 581 Doctor of Philosophy (PHD) 605
Master of Electrical Engineering (MEE) 514 Professional Certification (PRO CER) 104
Master of Engineering (MENGI) 580 Professional Certification * (PRO CERB) 164
Master of Fine Arts (MFA) 506 Professional Certification ** (PRO CERQ) 764
Master of Hospitality Management (MHM) 533 Professional Certification *** (PRO CERM) 564
Master of Industrial Engineering (MIE) 516 Professional Certification **** (PRO CERQ) 664
Master of Letters (ML) 537 Professional Development (PRO DEV) 105
Master of Music (MM) 507 Sarjana (SARJANA) 131
Master of Mechanical Engineering (MME) 518 Sarjana * (SARJANAB) 169
Master of Public and Int’l. Affairs (MPIA) 540 Sarjana ** (SARJANAQ) 769
Master of Science (MS) 503 Sarjana *** (SARJANAM) 569
Master of Science in Acoustics (MSAC) 526 Sarjana **** (SARJANAD) 669
Master of Science in Accountancy (MSACY) 508 Second Degree (SECDEG) 134
Master of Science in Admin. (MSADMN) 509 Will transfer to other school pp to complete degree (TRAN DEG) 106 Master of Science in Biomed. Eng. (MSBE) 527 Visiting student for semester Master of Science in Civil Eng. (MSCE) 513 pp (include summ trans) (VIS STU) 107 FOR OFFICE USE ONLY Master of Science in Chemical Eng (MSCHE) 511
Master of Science in Electrical Eng (MSEE) 515 * First undergraduate degree Master of Science in Environ. Eng. (MSENVE) 528 ** First undergraduate degree plus 30 credit hours or one year of graduate studies *** First graduate degree Master of Science in Industrial Eng (MSIE) 517 **** Highest graduate degree Master of Science in Materials Eng (MSMATE) 530 + First degree ++ Second degree Master of Science in Mech. Eng. (MSME) 519 +++ Third degree Master of Science in Occup. Ed. (MSOED) 524 ++++ Fourth degree
Master of Science in Oper. Resrch. (MSOPR) 529 †12–13 years of primary and secondary are required prior to the figure listed on all of the above. (E.g. Students from Philippines who only completed 10 years of primary and secondary prior to university Master of Science in Occup. Tech. (MSOT) 536 studies, and whose bachelor degree required 4 years to total 14 years of formal education should indicate “2” as number of years required fordegree.) FOR OFFICE USE ONLY