International Student Admissions

Complete the following ONLY if you are a non-U.S. citizen

Name:
Last First Middle
Country of Citizenship: Country Issuing Passport:

Birthplace: What is your primary language:

If you are seeking enrollment in college level courses, a Test of English as a Foreign Language (TOEFL) must be taken. Developmental English and/or Reading may be required if you do not have a TOEFL score.

Date of Test: Score:
Note: Crowder College will require proof of your testing: A TOEFL score of 550 is required for enrollment in college level courses.

If you are seeking enrollment in the Crowder College English Language Institute, you must provide proof of graduation from high school.

Name of School: Date of Graduation:

Immigration Status (For students who are currently in the U.S.)
Please circle your current U.S. immigration status: F-1 F-2 J-1 J-2 B-1
Other

What is the date of your original entry into this status?

Which university or other organization issued the I - 20, IAP-66 or other document used in maintaining your current status?

What are the issue and ending dates of this document?
Issue Date: Ending Date:

Please indicate the admission number from your I - 94:

Financial Support

Note: Each funding resource listed must be accompanied by an official statement. Send to:
Crowder College, 601 Laclede, Neosho, MO 64850
Self-Support
Show amount in U.S. dollars and attach official bank statement(s)
Parent(s) or individual sponsor(s)
Name:
Relationship:
Occupation:
Annual income in U.S. Dollars:
Do you have relative living in the U.S. Yes No
What relation?
Your government or other sponsoring agency
Name of government or agency:
Do you need a letter of admission to secure financial support from your sponsoring agency?
Yes No
Other form of support
Please explain:
Total

Application for Admission

Application Procedure

To be admitted each student must submit a completed
Crowder College Application for Admission

If you need special accomodations, please contact
Sonya Pearson, Dean of Student Services

This application is being submitted for:
  College Credit Coursework - please submit the following:
  • Official transcript from an accredited high school stating date of graduation or G.E.D. scores
  • Official transcripts from any previously-attended, post-secondary institutions
  • Placement testing scores from the COMPASS test
Non-Credit Coursework
  • Community Education
  • Environmental Health & Public Safety
  • Business Training and Development Center
Please choose one:
Fall - Year
 Spring - Year
 Summer - Year

I. PERSONAL INFORMATION
(to be completed by all students)

Complete Legal Name:
Last First Middle

Former Names (if any):

Social Security Number: Date of Birth:
Marital Status Married Single
 Gender: Female Male

Crowder Email Address Personal Email Address

Mailing Address
Street Address
City State Zip Code
Permanent Legal Address and Phone Numb *ome country physical address
Street Address
City State Zip Code
Country Country Code Phone Number

How long have you lived at your permanent legal address? years months
Race: (Optional) Hispanic/Latino White Black/African American Asian American
Hawaiian Native/Pacific Islander American Indian/Alaska Native
Other

Citizenship: U.S. Permanent Resident Alien Other Please Specify:
If you need special accommodations, please contact Sonya Pearson, Dean of Student Services.
Native Language: English Other

II. EDUCATIONAL INFORMATION
Student Status: First time student at any college (FT)
Former student at Crowder College (FR)
Have you attended another institution since attending Crowder? Yes No
Transfer student (prior credit at another institution but first time at Crowder College) (TR)
Transient Student (non-degree seeking at Crowder; taking one class to transfer to another institution (TS)

Classification: Freshman (0-30 hours) (FR) Sophomore (0-30 hours) (SO)
Post Junior College (65+ hours) (PJ) Post Baccalaureate (PB)
Special (no GED or High School Diploma) (SP) High School Student (HS)
(expected grad date: )

SECONDARY SCHOOL/G.E.D. INFORMATION

I graduated from (Name of Secondary School)
in City State Country
on (Date of Graduation)

I completed the G.E.D. - State: Date:

Camp Scholarship Yes No
COLLEGE/UNIVERSITY INFORMATION
List all colleges and/or universities which you have attended. Official transcripts of all degree-seeking students are required to be on file by the fourth week of the semester
Name of School
City/State/Country

My primary goal in attending Crowder College is: (please select only one)
Improvement of existing job skills (1) Preparation for job to be attained (2)
College or University transfer credit (3) Personal Interest (4)

I expect to accomplish this goal by:
Selected Courses (1) Certified Courses (2)
Associate of Arts (3) Associate of Science (4)
Associate of Applied Science (5)

Program of Study

III. EMERGENCY INFORMATION


Person to contact in case of an emergency:
Name: Phone Number:

Name of physician and phone number of hospital you wish to be transported to in case of an emergency:
Name: Phone Number:

In case of an emergency, I authorize college personnel in charge to use their discretion regarding the college's emergency procedures. I understand that falsification of any information provided on this application will subject me to disciplinary action, which may result in my dismissal from the college.
Name: Date:

IV. REMINDER AND INFORMATION


To assist in processing your application promptly, be sure to mail or fax all necessary documentation (unofficial copies of your academic records, test scores) to:

International Admissions Office
Crowder College
601 Laclede
Neosho MO 64850

Or fax records to 417-455-5731


The $25 application fee is also due at this time. You may mail a check, made payable to Crowder College, to the address above. To submit payment using your credit card click here:

Your application will be held until receipt of all documents is complete. Materials become the property of Crowder College and cannot be forwarded elsewhere.

I certify that the answers given in this application are complete and accurate to the best of my knowledge, and I understand that submission of false information may result in my denial or suspension.

Name: Date:

In the absense of a written signature, if you agree to the above terms, please select the SUBMIT button.