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Date of Birth (mo/day/year):
(example: 3/25/1988 for 25 March 1988)
Are you currently in the US?
If yes – what is your immigration status (e.g. F-1)
Country of Birth:
City of Birth:
Country of Citizenship:
Student Email Address:
Agent Email Address (optional):
Permanent Home Address (as would appear
on an envelope):
Current Mailing Address (as would appear
on an envelope):
Current Mailing Address - Is this Your Address Or Agent's Address
Home Telephone Number:
Other or Agent Telephone Number:
I plan to study at IIE. If checked, do not fill in Language Test Information.
I am a native speaker of English. If checked, do not fill in Language Test Information.
I have other evidence of English language proficiency.
I have taken an English language test (for acceptable scores please see English Language Requirements).
Type: Date (must be within the last 2 years):
I will take an English language test:
Associate degree (2 year)
Bachelor degree (4 year)
Second Major (optional):
(Check all that apply):
I am applying directly from secondary school or I have less than 14 transferable credits of post-secondary study.
I have completed high school with at least a 2.0 Grade Point Average (GPA) on a 4.0 scale.
I have an SAT/ACT Score. Score: Date:
I am a transfer student from a US or non-US school.
If IIE checked do not fill in this information.
Not needed if studying at IIE only.
List in order of attendance all secondary and post secondary education (high school and college)
Do not omit schools. Each school listed must submit an official transcript.
Name of school:
Degree/Number of credits earned:
Check if interested in applying for an athletic scholarship.
Volleyball (female only)
IIE start date:
How many IIE 8-week terms:
LCSC Start - Fall Spring Year:
LCSC Residential Halls
Private rentals/shared accommodation
If other, please explain
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