International Student Application
Personal Information
Last (family) name:  
First name: Middle Initial
Previous last (family) name(s) Gender:
Birth date: Birth month: Birth day:
 Birth Year:
Country of birth:
Country of citizenship:
Native language(s):
Ethnic origin:
Response is optional and not used for admission decision.

Mailing information
US Mailing Address
Address number/street:  
Apartment number:  
City:  
State: Zip code:
Telephone: Fax:
E-mail:  
 
Home Country Address
Address number/street: Apartment number:
Address line 2:  
City:  
State or Province:  
Country: Postal code:
Telephone: Country code: City code: Phone number:
Emergency contact: Name: Phone number:

Visa Information
Visa status
Are you currently in the United States? Yes No
If yes, what is your visa type?
Expiration date on I-94 card:

Program Information
I can begin classes:
Please choose a program and select whether it is a degree or certificate.

Optional Information
Have you taken the TOEFL test?


If yes, when did you take the test?
If yes, what was your score?
If no, when do you plan to take it?
Check here for up-to-date TOEFL information! (opens new window)

Previous Education
School Name
City and State
Years Attended
Graduated?

 

 
From
To
  

Last primary school attended:

 


Last high school attended

Last college, vocational /technical school attended

Degree:

Other college, vocational/technical school attended

Degree:

Your questions or comments are welcome:
         
This form will be submitted to the LWTC International Program Office.