FLORIDA GATEWAY COLLEGE 149 SE COLLEGE PLACE ● LAKE CITY, FLORIDA 32025-2007 www.fgc.edu [email protected] PHONE: 386-754-4361 FAX: 386-754-4861

INTERNATIONAL STUDENT APPLICATION FOR ADMISSION

ADMISSION APPLICATION PROCEDURES: International students who enter the United States under a non- immigrant student Visa will be admitted for specified terms only. A Florida Gateway College Certificate of Eligibility I-20 form will be issued only after ALL of the following documents have been received in Enrollment Services. Please mail complete application packet to: FGC Enrollment Services at the address noted above.

Name: ______Last (Family) First (Given) Middle

IMPORTANT DEADLINES

FALL TERM SPRING TERM SUMMER TERM

Applicants Outside the U.S. Applicants Outside the U.S. Applicants Outside the U.S. May 31 September 30 February 15 U.S. Transfer Applicants U.S. Transfer Applicants U.S. Transfer Applicants June 20 October 31 March 7

Admissions Notifications Mailed Admissions Notifications Mailed Admissions Notifications Mailed

June-July September-November February-April

ADMISSION REQUIREMENTS:

1. FGC International Student Application for Admission – Please submit a completed application for admission providing all required documents in one complete packet. An incomplete application will not be processed.

2. Certificate of Financial Responsibility – You must provide proof of funds for your first year tuition and living expenses before we can issue the required Form I-20 you will need when applying for your F-1 or M-1 Visa. The current international student estimated expenses for 12 months is 25,000 U.S. dollars ($25,000.00).

3. High School Equivalency Education – All foreign education transcripts must be translated and evaluated by a National Association of Credential Evaluation Services (NACES) approved foreign credential evaluation and translation service provider. An official report must be submitted from the evaluating agency directly to Florida Gateway College/Attn: Enrollment Services.

4. College or University Level Courses - All transfer-in College and/or University transcripts must be translated and evaluated by a National Association of Credential Evaluation Services (NACES) approved foreign credential evaluation and translation service provider. A detailed course-by-course evaluation must be completed and submitted from the evaluating agency directly to Florida Gateway College/Attn: Enrollment Services.

5. TOEFL Scores – If English is not the native language of your country you will be required to present TOEFL scores that are less than two (2) years old. The minimum official scores which are acceptable for admission are as follows: Paper-based test: 500; Computerized-based test: 173; and the internet-based test is 61.

6. All Students – All students must report to Enrollment Services upon arrival to meet with the International Designated School Official (DSO). Students will need to present all immigration documents and their passport. This will include the Form I-20 and Form I-94. International students are required to have student medical insurance which will cover medical costs while in the U.S. Students will be required to provide proof of medical insurance coverage upon arrival.

First-time college students are required to take an entry level college placement test such as the ACT, SAT or PERT. This must be done prior to registration for courses. If you have not taken one of these tests or do not have official test scores, you will be required to take a placement test upon arrival, before meeting with an academic advisor. Tuition and fees are due at the time of registration and may be paid in cash, check, or money order in U.S. currency. Rev. 2/2017 PLEASE COMPLETE ALL SECTIONS IN FULL (please print):

PERSONAL & IMMIGRATION INFORMATION (SEVIS Student Data) Do you have a U.S. Social Security Number: □ Yes □ No If yes, what is your SS# ______- __ __ - ______

NOTIFICATION OF SOCIAL SECURITY NUMBER COLLECTION AND USE: In compliance with and pursuant to Florida Statute 119.071 (5), 1008.386, 1002.22(2), and SBE Rule 6A – 1.0955 (3) (e), Florida Gateway College (FGC) issues this notification regarding the purpose of the collection and use of your Social Security number. FGC collects your Social Security number for use in performance of the college’s duties and responsibilities. In a seamless K-20 educational system, it is beneficial for postsecondary institutions to have access to the same information for purposes of tracking and assisting students in the transition from one educational level to the next. Federal legislation relating to the Hope Tax Credit requires that all postsecondary institutions report the Social Security number of all post-secondary students to the Internal Revenue Service (IRS). This IRS requirement makes it necessary for colleges to collect the Social Security number of every student. A student may refuse to disclose his/her Social Security number to the college, but refusing to comply with the federal requirement may result in fines established by the IRS. Providing your SSN on this form signifies that you consent to the use of your number in the manner described. To protect your identity, FGC will secure your Social Security number from unauthorized access. FGC will never release your Social Security number to unauthorized parties, and each student at FGC will be issued a unique student identification number. Your unique student identification number is used for all educational purposes at FGC including registration, access of your online record, etc. All Social Security numbers are protected by federal regulations and are never released to unauthorized parties. For additional detailed information on the college’s collection and use of social security numbers, please visit the college’s website at https://www.fgc.edu.

Name: ______Last (Family) First Middle

Mailing Address (Outside of the U.S.) :______Number and Street/Apt.# (required for I-20 processing)

______City County/State/Region/Province Postal Code Country

______Telephone Number E-mail address

Mailing Address (United States): ______

______City State Zip Code

______Telephone Number (include area code) E-mail address

Disclosure of information collected in the box below is not mandatory; however, it is requested to aid the State of Florida in its commitment to Equal Educational and Employment Opportunity and to meet federal reporting requirements. It is not used discriminatively for admission purposes. Refusal to answer the information requested will not result in the adverse treatment of any applicant.

Date of Birth: _____/_____/_____ Race (check one) Month Day Year □ American Indian/Alaskan Native Gender □ Female □ Male □ Asian □ Black/African American Ethnicity (check one) □ Native Hawaiian/Pacific Islander □ Hispanic or Latino □ Not Hispanic or Latino □ White

Primary Language______

Country of Birth ______Country of Citizenship ______

Will you bring dependents to the U.S.? □ Yes □ No Number of dependents: ___ (list dependents on page 2 of application)

Are you currently in the U.S.? □ Yes □ No If yes, what date did you enter the U.S.?: ______/______/______Month Day Year

VISA HOLDERS: Will you exit and re-enter the U.S. if issued an I-20? □ Yes □ No

Type of Visa: ______Expiration Date: ______/______/______I-94 Number: ______

Rev. 2/2017 Are you transferring from another U.S. school? □ Yes □ No Name of School: ______

If accepted, please indicate address where the acceptance letter and I-20 form should be mailed: □ United State (address listed above) □ Outside the United States (address listed above) □ Pick Up in Person by: ______□ Other: ______

Emergency Contact: ______E-mail: ______

Telephone: ______City State/Region/Province Postal Code Country

EDUCATIONAL PLAN: INTENDED STARTING DATE: □ Fall □ Spring □ Summer Year: ______

Please enter the degree code which corresponds to your educational plan. Majors/Courses of Study can be found at https://www.fgc.edu/wp-content/uploads/2016/11/Programs-of-Study-12-2016.pdf .

I plan to complete one of the following: □ Earn a Certificate and/or Applied Technology Diploma: Major/Course of Study Program Code: ______□ Earn an Associate in Arts (university transfer). Major/Course of Study Program Code: ______□ Earn an Associate in Science degree (may not transfer). Major/Course of Study Program Code: ______□ Earn a Bachelor’s Degree at Florida Gateway College. Major/Course of Study Program Code: ______

Have you taken the TOEFL test? □ Yes □ No If yes, please list your test scores below. You must submit your official test scores with your application. Computer Test: _____ Paper Test: ____ Internet Based: ______. If you have not taken the TOEFL when do you plan to take the exam? ______/______/______.

HIGH SCHOOL/COLLEGE INFORMATION: All foreign educational transcripts must be evaluated by a NACES approved academic credential evaluating agency. All transfer-in College and/or University transcripts must be translated and evaluated with a course-by- course evaluation conducted. The official evaluation/report must be submitted from the evaluating agency directly to FGC - Attention: Enrollment Services.

Name as it appears on high school records: ______Last (Family) First Middle

Name of High School: ______

Location: ______Graduation Date: _____/_____/_____ City County/State/Region/Province Country Month Day Year

Were examination scores required for graduation? □ Yes □ No Do you have verification: □ Yes □ No

COLLEGE/UNIVERSITY INFORMATION: List all colleges or universities that you have attended. Do not abbreviate school names. Attach an additional sheet if necessary. Please do not include non-credit English language study. COLLEGE/UNIVERSITY LOCATION YEARS ATTENDED DEGREE EARNED

Rev. 2/2017 DEPENDENT INFORMATION: If bringing dependents, please include the following information on each. Attach an additional sheet if necessary. Please print. Last (Family) Name First Name Middle Name Date of Birth Relationship

1.

2.

3.

How did you hear about Florida Gateway College? □ Internet □ Friend/Relative □ Publication □Other ______

I hereby apply for admission to Florida Gateway College as an international student. I have checked the application for error and certify that the information is accurate and complete. I agree to abide by all rules and regulations of the College. I understand that in addition to this application I must submit all required documents to be considered for admission.

Applicant’s Signature: ______Date Signed: ______

Florida Gateway College is a member of the Florida College System. Florida Gateway College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award the baccalaureate and associate degree. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097, or call 404-679-4500 for questions about the accreditation of Florida Gateway College. The Commission is to be contacted only if there is evidence that appears to support an institution’s significant non- compliance with a requirement or standard. FGC will adhere to all applicable federal, state, and local laws, regulations, and guidelines with respect to providing reasonable accommodations as required to afford equal educational opportunity. Students may obtain further assistance and information by calling Terry Auger, coordinator of disability services, at (386) 754-4215. The Disability Services Office is located in Building 017, Room 021, 149 SE College Place, Lake City, Florida 32025. Florida Gateway College does not discriminate in education or employment related decisions on the basis of race, color, religion, national origin, gender, age, disability, marital status, genetic information, or any other legally protected status in accordance with the law. The Equity Officer is Sharon Best, director of human resources,149 SE College Place, Lake City, FL 32025, and may be reached at (386) 754-4313

Rev. 2/2017

FLORIDA GATEWAY COLLEGE F-1 Visa Applicants CERTIFICATE OF FINANCIAL RESPONSIBILITY

The United States Citizenship and Immigration Services require Florida Gateway College to obtain documentary evidence of financial support of all applicants for an F-1 visa. The Affidavit of Financial Support verifies that the student has sufficient funds to support themselves while studying in the U.S. The student, sponsor or other sponsoring agency must prove that a minimum of $25,000 (U.S. dollars) per year is available for tuition and living expenses. Applicants must submit valid supporting documents verifying access to the funds. ESTIMATED EXPENSES (in U.S. currency): Current international student estimated expenses for 12 months or two (2) semesters (fall & spring) of study at 12 semester credit hours per term. Please note: these amounts are subject to change.

►TUITION:$10,000 ► BOOKS AND SUPPLIES: $3,000 ► LIVING EXPENSES: $12,000: TOTAL: $25,000

The above amounts are based on the assumption that a student is careful in the use of his/her funds, does not plan to purchase an automobile and has no dependents. Students must have sufficient funds to pay for their tuition in full at the time of registration each term.

APPLICANT INFORMATION:

Name: ______Last (Family) First Middle

Date of Birth: ______/______/______Country of Citizenship: ______Number of Dependents: ______Additional resources required for each dependent

Enrollment Plan: □ Certificate/Applied Technology Diploma □ Associate’s Degree □ Bachelor’s Degree

SOURCES OF SUPPORT REQUIRED DOCUMENTS GUARANTEED SUPPORT IN U.S. DOLLARS Personal Funds (Liquid Assets *Official Bank Documents plus the Affidavit of $ Required) Support Section Below Parent or Sponsor *Official Bank Documents plus the Affidavit of $ Support Section Below Government or Sponsoring Agency Original or certified copy of award letter. $ Scholarship or Other Source: *Official Bank Documents and/or validated documentation from an authorized person of $ ______financial guarantee. Letter must state amount of support and period of coverage. TOTAL $ *Official Bank Documents – Original of official bank document signed by a bank official reflecting enough funds to cover the total estimated expenses (per year) related to your educational objective (see above). Photocopies of bank documents are unacceptable. FEES ARE DUE AT THE TIME OF REGISTRATION.

Rev. 2/2017 I hereby certify that the information on this form is true and accurate and that the stated funds are available for my educational expenses (note: medical insurance and dependent expense is not included). I understand that the submission of inaccurate information can be considered sufficient cause for rejecting my application and terminating my enrollment at Florida Gateway College.

Applicant’s Signature: ______Date Signed: ______

SPONSOR INFORMATION:

NAME:

______Last (Family) First Middle

Mailing Address:

______Number & Street/Apt # City County/State/Region/Province

______Country of Citizenship: ______Postal Code Country (Citizens or U.S. legal permanent resident must complete USCIC Form I-134)

AFFIDAVIT OF FINANCIAL SUPPORT - To be completed by a parent, family guarantor, or applicant even if support is personal funds.

This is to certify that I have read the information furnished by the student listed above and that I am willing and able to support him/her while enrolled at FGC. I certify that I can provide the amounts noted below for each year of enrollment. I have enclosed an official bank letter certifying the availability of funds as reflected below. ALL FUNDS MUST BE NOTED IN U.S. DOLLARS FEES ARE DUE AT THE TIME OF REGISTRATION.

1. Name of Sponsor/Guarantor (Please print) ______

Amount of Support I will provide: $ ______in U.S. currency.

Signature of Sponsor/Guarantor ______

Mailing Address: ______

Phone Number: ______Relationship to Student: ______

2. Name of Sponsor/Guarantor (Please print) ______

Amount of Support I will provide: $ ______in U.S. currency.

Signature of Sponsor/Guarantor ______

Mailing Address: ______

Phone Number: ______Relationship to Student: ______

Rev. 2/2017