Non-degree seeking, international undergraduate

Student Application Form
*Required

I, , understand that this Application is for the purpose of studying at Texas State as an non-degree seeking student and will not be considered for admission to any degree-awarding program at Texas State University.

Print Name: ______Date: (mm/dd/yyyy)

Semester(s) of study at Texas State*: Fall (August-December): ______Year

Spring (January-May): ______Year

Summer (June-July): ______Year

Personal Information

First Name (Given Name)*: Gender: M F

Last Name (Family Name)*:

Date of Birth (mm/dd/yyyy)*:

Primary Email Address*:

Country of Citizenship*:

Native Language*:

Do you have any dependents (spouse, children, etc.) traveling with you to Texas State University that will need to have immigration documents created based on your application?

Yes No
______

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Permanent Address

Street Name & Number: City:

State or Province:

Country:

Postal Code / Zip Code*

Permanent Telephone Number (in your home country)*

Cell Phone Number*

Note: please include area code

______

Current Address

Current Street Address (if different from permanent address above)

Street Name & Number: City:

State or Province:

Country:

Postal Code / Zip Code*:

Current Telephone Number:

Cell Phone Number*

Note: please include area code

______

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Emergency Contact Information

Please list names of emergency contacts that Texas State University can contact in case of emergency*

1. Name

2. Relationship a student

3. Phone Number

(include area code)

4. Email

You must attach the following documents to this application:

·  Transcript* - Please attach a copy of your most recent academic records to the end of this packet (with its translation in English).

·  Proof of a Language Proficiency

By signing this form you declare that all information given on this form is true and accurate to the best of your knowledge.

Print Name: ______Date (mm/dd/yyyy):

On-campus Housing

Residential Hall Preferences

If planning to live on campus, please click here to review all residence hall choices. Then please complete the Housing Preferences Form below with your three residence hall choices.

Note: The exchange students from Kansai Gaidai University please select one of the following residential halls:

·  Arnold

·  Beretla

·  Brogdon

·  Elliot

·  Jackson

·  Lantana

·  Lourek

·  Retama

·  Smith Sterry

Housing Preferences Form

I, ______, choose three of the following on campus accommodations are my top preferences for living at Texas State University. I understand that listing these three options does not mean I am guaranteed a room in one of these accommodations.

1.

2.

3.

Print Name: ______Date (mm/dd/yyyy):

Home University: ______

Study Abroad Office

601 University Drive | Thornton International House | San Marcos, Texas 78666

phone: 512.245.1967 | fax: 512.245.1644 | www.studyabroad.txstate.edu