International Student Application Form | Western Michigan University

Western Michigan University
International Student Application Form

NAME OF APPLICANT (as it appears on official documents)


Family Name	Given Name

U.S. Social Security Number (if available)

PERMANENT HOME COUNTRY ADDRESS (REQUIRED)


(Number)	(Street)


(City)	(State/Province)	(Zip/Postal Code)	(Country)

MAILING ADDRESS


(Number)	(Street)


(City)	(State/Province)	(Zip/Postal Code)	(Country)

Gender:		Male		Marital Status:		Married
		Female				Single

CITIZENSHIP (Country):

DATE OF BIRTH		City and Country of Birth
	Month/Day/Year

PHONE #

FAX #

E-MAIL

Degree applying for (mark one):

Bachelor's
Master's
Doctorate

Enrollment date (mark one):

	Fall (Sept. - Dec.) 2009
	Sring (Jan. - April) 2010
	Summer I (May - June) 2010

U.S. VISA TYPE HELD

OR EXPECTED

SUBJECT I WANT TO STUDY (Programs list: international.wmich.edu/content/view/27/52/):

OBJECTIVE TEST(S) YOU HAVE TAKEN OR PLAN TO TAKE:

TOEFL		DATE
GMAT		DATE
GRE		DATE
OTHER ENGLISH TESTS		DATE

List below all secondary and post-secondary institutions you have attended or are attending:

Institution	Dates of attendance	Degree/diploma received

*Conditional Admission/English Proficiency: If I am eligible for a Western Michigan University program, but am unable to document the required English proficiency, please consider me for conditional admission and enrollment in CELCIS, WMU's intensive English program.

Please Check:

	YES	Note desired semester and year of CELCIS enrollment (Fall, Spring, Summer I/II):
	NO	I do not wish to be considered for CELCIS enrollment.

*Student Certification:I certify all information on this application is complete and accurate to the best of my knowledge. I have also read carefully the costs of enrollment and am prepared to meet these expenses. Failure to report all institutions attended will invalidate my application and may result in dismissal if admitted.

Signature

Date

Application fee (U.S. $100.00 non-refundable) payment information

	YES, I am enclosing a check for U.S. $100.00 drawn on a U.S. bank made payable to Western Michigan University.
	YES, I authorize Western Michigan University to bill my credit card U.S. $100.00 for the application/document fee.

Credit Card Type

VISA

Mastercard

Discover

Account Number

Expiration Date

(Month/Year)

3-Digit code

(found on back of card/signature panel)

Name on Card

Signature

** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **

International Student Application Form | Western Michigan University

WESTERN MICHIGAN UNIVERSITY
STATEMENT OF FINANCES

NAME OF APPLICANT (as it appears on official documents)


Family Name	Given Name

U.S. Social Security Number (if available)

ADDRESS


(Number)	(Street)


(City)	(State/Province)	(Zip/Postal Code)	(Country)

CITIZENSHIP (Country):

Please provide proof that funding is available. Personal/family funds must be verified by a bank statement. If sponsored by your government, an official letter must be submitted showing that the scholarship is valid for use at WMU, indicating beginning and ending dates of validity.

Following is a list of estimated expenses which the typical student is expected to pay during each academic year of full-time enrollment (for 2009-2010 academic year, Eight months, 24-32 hours Undergraduate, 12 hours Graduate).

Cost Categories	Undergraduate	Undergraduate	Graduate
	Lower Division (freshman/sophomore)	Upper Division (junior/senior)
Tuition & Fees	$ 19,552.00*	$ 21,684.00*	$ 10,986.00*
Room & Board	7,784.00	7,784.00	7,784.00
Books & Supplies	1,000.00	944.00	1,600.00
Medical Insurance	1,589.00	1,589.00	1,589.00
TOTAL	$29,925.00	$32,001.00	$21,959.00

The above figures are based on tuition and fees listed below. Tuition and fees are subject to change by the WMU Board of Trustees.
- Undergraduate Lower Division (freshman/sophomore level classes) students are charged a flat rate of $9,387.00 for 12-16 credit hours.
- Undergraduate Lower Division (freshman/sophomore level classes) students are charged $649.24 per credit hour over 16 credit hours a semester.
- Undergraduate Upper Division (junior/senior level classes) - $10,453.00 for 12-16 credit hours.
- Undergraduate Upper Division (junior/senior level classes) - $722.90 per credit hour over 16 credit hours a semester.
- Graduate students are charged $850.62 per credit hour each semester.

Fees per semester*

International students are charged a $25.00 per semester / $12.50 per session fee
All students are charged an enrollment and student assessment fee of $356.00 per semester / $177.50 per session.
In addition, all students are charged a one-time records initiation fee of $300.00 upon entering WMU.
Room and board costs are approximately the same on and off campus.
The University requires that all students be covered by adequate medical insurance.
Additional $4,000.00 per spouse/child will be required if you plan to bring your dependent(s) to the U.S.
Personal/incidental fees are not included in the above costs.
For details on fees, please refer to WMU Registrar's Office Web site at www.wmich.edu/registrar/tuition/index.html

Name of Sponsor (please print or type):

Relationship of Sponsor to Student:

If Funds Are Provided by an Organization, Give Name and Address of the Group:

** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **

International Student Application Form | Western Michigan University

Western Michigan University
International Student and Dependent Information

SECTION 1 (Everyone must complete this section, even if you do not have dependents)


Family Name	Given Name	Middle Name

U.S. Visa type held

U.S. Social Security Number (if available)

Or Expected

CHECK ONE OF THE FOLLOWING:

___ I do not have any F-2 or J-2 dependents (F-2 or J-2 visa holders) here in the U.S.
(This section is complete. Please proceed to Section 3)
___ I do have F-2 or J-2 dependents (F-2 or J-2 visa holders) here in the U.S.
(Complete Section 2 and 3)
___ I do have dependents twho will be applying for an F-2 or J-2 visa to enter the U.S.
(Complete Section 2 and 3)
___ I do have dependents but they will not be applying for an F-2 or J-2 visa to enter the U.S.
(Information is complete. Please proceed to Section 3)

SECTION 2

If you have checked #2 or #3 above you MUST complete SECTION 2. If you have checked #1 or #4, skip this section and proceed to Section 3. Failure to provide this information will result in ineligibility for a U.S. VISA and/or loss of VISA benefits.

DEPENDENT #1 Information


Family Name	Given Name	Middle Name

DATE OF BIRTH (M/D/Y)

Female

Male

COUNTRY OF BIRTH

COUNTRY OF CITIZENSHIP

RELATIONSHIP TO APPLICANT

Spouse

Son

Daughter

U.S. VISA TYPE HELD

OR EXPECTED

DEPENDENT #2 Information


Family Name	Given Name	Middle Name

DATE OF BIRTH (M/D/Y)

Female

Male

COUNTRY OF BIRTH

COUNTRY OF CITIZENSHIP

RELATIONSHIP TO APPLICANT

Spouse

Son

Daughter

U.S. VISA TYPE HELD

OR EXPECTED

DEPENDENT #3 Information


Family Name	Given Name	Middle Name

DATE OF BIRTH (M/D/Y)

Female

Male

COUNTRY OF BIRTH

COUNTRY OF CITIZENSHIP

RELATIONSHIP TO APPLICANT

Spouse

Son

Daughter

U.S. VISA TYPE HELD

OR EXPECTED

DEPENDENT #4 Information


Family Name	Given Name	Middle Name

DATE OF BIRTH (M/D/Y)

Female

Male

COUNTRY OF BIRTH

COUNTRY OF CITIZENSHIP

RELATIONSHIP TO APPLICANT

Spouse

Son

Daughter

U.S. VISA TYPE HELD

OR EXPECTED

**IF ADDITIONAL SPACE IS NEEDED PLEASE PROVIDE INFORMATION ON ANOTHER SHEET OF PAPER AND ATTACH TO THIS DOCUMENT**

SECTION 3 (Everyone must complete this section)

Student Certification: I certify that all information on this form is complete and accurate to the best of my knowledge.

Signature

Date

Please return application to:

International Admissions and Services
Haenicke Institute for Global Education
Western Michigan University
4255 Ellsworth Hall
1903 W Michigan Ave
Kalamazoo, MI 49008-5246 U.S.A.
Phone: 269-387-5865 Fax: 269-387-5899
Email: oiss.info@wmich.edu, Web: http://international.wmich.edu

** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **