ISP application Page 1 of 5 Revised 8/23/19
International Student Program (ISP) Evergreen Valley College 3095 Yerba Buena Road
San Jose, CA 95135 Room SC 214B
Tel: 001.408.223.6740
International Student Program (ISP)
Application Packet
Applicant’s Name:
Intended Starting Term:
Telephone:
Email:
ISP application Page 2 of 5 Revised 8/23/19
International Student Application Checklist It is the applicant’s responsibility to check if all documents required are prepared for submission. Applicants should be aware that incomplete application WILL delay the admission process.
1. ISP Application (see pages 3-5)
2. EVC Application: PDF form
Please complete all fields to the best of your ability. Print it. Submit the PDF Application along with item
#1.
3. Two color photos (passport type)
4. Transcripts from your high school and colleges you have attended before
5. English Proficiency Report (Test reports MUST be sent directly by testing agency. School code: 4273) • TOEFL: Minimum score based on test type: 500 – paper based exam; 173 – computer based exam; 61
–Internet based exam.
• IELTS: 6.0 +
• iTEP Academic: 3.7+
• Cambridge English: Level B2: First (FCE) or Advanced (CPE): 175 +
• PTE (Pearson Test of English): 42+
If the applicant has completed degree applicable courses in English with a grade of “C” or better (at an accredited U.S.
college/university), the English Proficiency requirement may be waived.
English Proficiency exemption applies to native English speakers such as the United Kingdom, Australia, New Zealand, and
Canada (except Quebec) where English is both the only official language of the country and the language of instruction.
6. Original Bank Verification (signed by a certifying official) with minimum balance of US$22,000 from parent(s) or a sponsor dated within 6 months of application date.
7. Letter of Financial Support or Affidavit of Support form from a parent or a sponsor
8. Copy of passport biographical information page
9. TB Skin Test results. If results are positive, a chest x-ray will be required. Exams must be dated within 6
months of application date.
If applying for admissions in the U.S., in addition to the above-listed, the following items are also required:
10. Copy of your current visa, Information pages and I-94 Card from your passport
11. If you are currently have F-1 Student Visa:
i. Copy of your Form 1-20
ii. Transcripts from current school
iii. Transfer authorization letter from the current school (may be provided upon acceptance)
Evergreen Valley International Student Program (ISP) Tel: 001.408. 223.6740 [email protected]
Evergreen Valley College 3095 Yerba Buena Road, San Jose, CA 95135 www.evc.edu
ISP application Page 3 of 5 Revised 8/23/19
International (F-1) Student Application
International Student Program (ISP) Evergreen Valley College 3095 Yerba Buena Road, San Jose, CA 95135 Tel: 001.408. 223.6740 [email protected]
I am applying for:
FALL 20_________ Spring 20________
NAME Last (Family) as appears in your Passport First (Given) Middle
Date of Birth (mm/dd/yy) Female Male Primary Language
Country of Birth Country of Citizenship
Degree / Program of Study (to view a complete listing, visit: http://www.evc.edu/AcademicAffairs/Documents/degrees-certificates.pdf
Number and Street Number and Street
City City
State/Province/Prefecture State/Province/Prefecture
Country Postal Code Country Postal Code
Cell /Tel # (include country code) Cell /Tel # (include country code)
Preferred E-Mail Address
Home Country – Permanent Address: Local/ U.S. Address (not a P.O. Box):
Where would you like your I-20 and acceptance letter mailed? Check one box only
Home/Permanent Local/Current Agency name:
Other, shown below:
Contact Person
Complete Address
Phone # & E-mail Address
Evergreen Valley
ISP application Page 4 of 5 Revised 8/23/19
REFERRAL SOURCE/AGENT INFORMATION
How did you learn about Evergreen Valley College (EVC)? EVC website Referring agency Fair/Seminar Advertisement Friends/Relative If the application is submitted by an education advising agency, please complete the following:
Agency Name: _______________________________________ Contact Person’s Name: ___________________________ Email Address: ________________________________________ Phone Number: __________________________________ Address: _______________________________________________________________________________________________________
If you are in the U.S. now, please indicate your current visa type: ________________________________________
Date of entry into the U.S.: _____ / _____ / ______ Visa Expiration Date: _____ / _____ / _______ Month Day Year Month Day Year
If you don’t have F-1 visa, where will you be applying for it? Within the U.S. From your home country If currently on an F-1 visa, what institution issued your Form I-20? ________________________________
ENGLISH PROFICIENCY:
TOEFL Test __________ (score) IELTS Test _________ (score) Test Date: _____ / _____ / ______ Test Date: ______ / _____ / ______ Month Day Year Month Day Year
EDUCATIONAL BACKGROUND: (please list your high school and any college attended)
High school Attended City/Country Date Completed Diploma
University/College Attended (If any) City/Country Date Completed Diploma/Degree
TO BE COMPLETED BY STUDENTS CURRENTLY STUDYING IN THE UNITED STATES ONLY
Name of U.S. school you are currently attending City/State Date Started
MARITAL STATUS: Single Married
Will Spouse/Children Accompany you to the U.S? YES (additional documentation/finances will be required) NO
Name Relationship to Applicant
ISP application Page 5 of 5 Revised 8/23/19
EMERGENCY CONTACT INFORMATION This information will remain on file for the duration of your enrolment. If a change occurs, please report to the International Programs & Services IMMEDIATELY. Emergency Contact Person: ______________________________________________________________________ Address: ____________________________________________________________________________________ Telephone Number: ___________________________________ Mobile Number: __________________________ (include country code) (include country code)
E-mail: ________________________________________________ Relationship to Applicant _________________________________
Does this person speak English? NO YES
As an International (F-1) Student attending Evergreen Valley College, I understand that I am encouraged to participate in a supplemental medical/emergency plan (to purchase and carry medical insurance). If I choose do not participate, I assume personal liability for any accident, health, hospitalization an any/all other medical related expenses incurred by me while attending EVC as an International Student. By signing this application, I am accepting all responsibility for my medical care and expenses.
Evergreen Valley College does not accept potential applicants that have been dismissed or terminated from other U.S. collegiate institutions for any reason. I hereby declare that I have never been dismissed or terminated by any other U.S. collegiate institution.
If accepted to EVC, I will follow the Standards of Student Conduct and Compliance with U.S. Immigration Laws & Regulations: The Role and Responsibility of the International Student that are published in the college catalog and website respectively, and I understand that failure to do so would be grounds for dismissal. I understand that, upon acceptance and arrival at EVC, students will be tested for English and Math proficiency in order to be placed at appropriate course level. All classes are conducted entirely in English; therefore students without sufficient placement may be referred to a language school/program until they are able to meet the standards necessary to successfully complete the required courses for their educational program.
THE STATEMENTS MADE BY ME IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWEDGE. I UNDERSTAND THAT ANY FALSIFICATION CONSTITUTES PERJURY AND MAY BE LEGAL BASIS FOR DISMISSAL
Student Name (please Print)
Student Signature Date
