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FOR OFFICE USE ONLY

ADMITTED/DENIED________________________________ INITIAL DATE

What visa status do you presently hold? �� F-1 ��� F-2 ��� B-1 �� B-2 �� M-1 � M-2 � None �� Other: ______________ I-94 Expiration Date: (mo/yr)________

What visa status are you applying for �� F-1 � M-1 Do you have any dependents? �� Yes � No (If yes, attach dependent’s passport)

Will you be applying for the student visa in your country? �� Yes �� No �� N/A

Will you be applying to change your visa status in the U.S.? �� Yes �� No �� N/A

Do you have a current I-20? �� Yes �� No Name of school attended__________________________ Dates attended___________________

Currently enrolled �� Yes �� No Do you have dependents currently on an I-20? �� Yes �� No

PROVIDE PREVIOUS EDUCATION HISTORY BEGINNING WITH HIGH SCHOOL

INTERNATIONAL STUDENT APPLICATION

AN EQUAL ACCESS/EQUAL OPPORTUNITY INSTITUTION REG-38 (Revised April/2016)

Broward CollegeOffice of International Admissions225 East Las Olas Boulevard, 1st FloorFort Lauderdale, FL 33301, U.S.A.

Student Number _______________________________________________________Complete all sections of this application before printing it. Submit the application and supporting documents as an email attachment to Int-Admissions@broward.edu.

PERSONAL INFORMATION

Legal Name (on passport) ____________________________________________________________________________________________

FAMILY NAME GIVEN NAME

Please check box where you wish admission correspondence to be mailed. � U.S. � Foreign

U.S. Address (if available) __________________________________________________________________________________________ City _____________________________________________ State___________ Zip_____________ Phone (in U.S.) __________________________________ E-Mail REQUIRED_______________________________________________ Foreign Address (in your home country) REQUIREDStreet Address __________________________________________________________________________________________________

City____________________________________ Province/Territory___________ Postal Code_____________ Country ______________ Phone (in home country) ________________________________ Native language ______________________________________________ Birthdate (Month/Day/Year) ____________ Country of Birth ___________________ Country of Citizenship ________________________ Race (Optional): (You may check one or more race categories, if applicable): � Asian � Black or African American � American Indian or Alaskan Native

� Hawaiian or Pacific Islander � WhiteEthnicity (Optional): � Hispanic � Non-HispanicApplied Term: (please check one) Fall Term: Year__________ Winter Term: Year__________ Summer Term: Year _________

Session 1: August-December Session 1: January-May Session 1: May-August

I will attend (check one)    � Central Campus, Fort Lauderdale � North Campus, Coconut Creek � South Campus, Pembroke PinesI am seeking the following program objective (add desired degree number from the back page of the application).

� B.S. degree _______ �� A.A. degree 1010 _____________________ � A.S. degree _________ � Language program 3005

Dates of AttendanceType of School

(high school, secondary,college/university, etc.)

Full name of schoolLocation of school(city and country)

Certificates, Diplomas,Degrees, Graduations

SAMPLE:From 2011 To 2015

From ________To________

From ________To________

From ________To________

From ________To________

From ________To________

From ________To________

From ________To________

If YES, please contact an immigration attorney for assistance.

B.S.: Must have 60 college level credits to apply for Bachelor's degree A.A.: Write the name of program/degree you want to study A.S.: Write the number of the program you want from page 4

high school Colegio La Salle Caracas, VENEZUELA Diploma de Bachiller

� Male � Female

CONFIDENTIAL FINANCIAL STATEMENTApplicants to Broward College and their sponsor should complete this form and

return it with a bank letter/statement showing U.S. funds available.

Name of Student ____________________________________________________ Citizenship _______________________Family Name / Given Name

Immigration requires that students submit documented proof of financial support.Broward College requires US$22,500 for an Associates degree or the Language program, US$27,500 for a Bachelor’s degree, or US$50,000 for a Professional Pilot degree be available per year. The college will only authorize up to the limit of tuition and books per term to be brought into the U.S. through wire transfer or check. Any additional funds received will be applied toward future terms and not refunded to the student.

Please state the amount in U.S. dollars available to the student for use each year in the U.S.A. _____________________

Please indicate the specific source of funds:

� Parents � Family (other than parents) � Student Loan Abroad or U.S.A. (copy of student loan approval required)

� Self � Government Scholarship or Loan � Other (please specify) ________________________________________

Please provide the name of person from whom funds will be obtained.

I (name of sponsor), ____________________________________________________________________________________

of (legal address, city, country) __________________________________________________________________________

will be a sponsor for ____________________________________________________________________________________

I will be responsible for his/her financial and personal support for the duration of his/her studies at Broward College.

Signature of Sponsor ________________________________________________ Date ____________________________

Broward College expects international students to have sufficient funds to cover all expenses.

GOOD CONDUCT AND CITIZENSHIP

Applicants who have experienced disciplinary problems at any educational institution or with other authorities (not including minor traffic violations) must state circumstances involved on a separate sheet and submit with this application. This information will not necessarily exclude applicants for admission, and will be handled confidentially.

I certify that all statements given in this application are true and accurate to the best of my knowledge. I agree to abide by all rules and regulations of Broward College. I agree that if any information is found to be false, I may be suspended from classes without a refund of any fees paid.

Applicant’s Signature ____________________________________________________________________ Date ________________

Parent’s Signature (if student is under 18) __________________________________________________ Date ________________

SOCIAL SECURITY NUMBER or TAX ID NUMBER

Social Security No. or Tax ID No. ________________________

If a student has a Social Security Number (SSN) or a Taxpayer Identification Number (TIN), federal law requires that it is furnished to Broward College so that it may be included on all documents filed by the institution with the Internal Revenue Service. Students who fail to furnish Broward College with the correct SSN or TIN may be subject to an IRS penalty of $100 unless the failure is due to reasonable cause and not to willful neglect.

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(write the amount according to the statement above)

Dear Student:Thank you for considering Broward College! We are delighted that you decided to apply for admission!The following documents are required for admission to the college. Please see additional baccalaureate degree requirements at www.broward.edu/international or on page 7 of the Admission Brochure.

1. International Student Application: send as an email attachment with the supporting documents to Int-Admissions@broward.edu� $75 non-refundable application fee can be paid online, with a credit card, once you have your student ID

2. Copy of education records through highest level of education completed (original documents will be required upon your arrival)� High School Diploma or General Equivalency Diploma (GED) - All applicants must have the equivalent of a U.S. high school diploma.

(High school diplomas do not have to be translated to English with the exception of Hebrew, Arabic or Asian) � High school for the British education system - Four academic passes (or three academic and two non-academic) on the GCE, CXC,

BGCSE, WAEC, WASC, or HKCE exams in General Proficiency certificates are required. High School diploma or transcripts are not required.

� Final, University or College transcripts along with a certified English translation, if applicable, are required. A minimum grade point average of 2.0 or its equivalent is required. (Language Program applicants are not required to submit university records unless students will continue with a degree program once the Language Program is completed.)

Please note: Bachelor degree applicants must have a commercial evaluation done of all university work completed outside the U.S., prior to admission. The commercial evaluation is optional for associate degree applicants if transfer credit is not desired.

3. Evidence of English proficiency (Native English speakers or applicants for the language program are not required to show evidence of English proficiency.)Degree seeking students must submit one of the following:� TOEFL - minimum score of 79 on the internet–based test or a minimum score of 550 on the paper-based test� IELTS - minimum score of 6.5.� Cambridge English Advanced - minimum score of 176� Broward College English as a Second Language Placement Test (LOEP). Applicants currently in US only.� Successful completion of ENG IV at a U.S .high school or university level English at an accredited U.S. university with a grade of C or

better

Please note:• All international students with required TOEFL, IELTS or Cambridge scores will be required to take the PERT test for placement.

Native English speakers will also be required to take the PERT test for placement.• In addition, students who are degree seeking, who do not place into college-level English on the PERT test, will be required to take

developmental education courses, which will not apply towards a degree.• All ESL (English as a Second Language) classes must be completed before starting a degree program.

4. Evidence of financial support� Confidential financial statement on the application must be completed and signed by financial sponsor� Bank statement, scholarship, or loan approval indicating that there are sufficient funds to cover the “total cost of education”

(tuition, fees, books, living expenses, transportation, and incidental expenses). � Each dependent will require additional funds in the amount of $7,000 US dollars

Total Minimum Balance Required:

� Associate Degree or Language Program: US $22,500� Professional Pilot Program: US $50,000� Bachelor Degree: US $27,500

(Fees are subject to change without notice)

5. Submit a copy of your current passport (page with the name and date of birth) and your dependents' passports (if applicable). If transferring the I-20 from another school to Broward College, please also send a copy of your I-20, I-94 and F-1 visa (if applicable).

Questions concerning international student admissions should be directed to:OFFICE OF INTERNATIONAL ADMISSIONSPhone: 954-201-7228, 954-201-7467, 954-201-7468 and 954-201-7245Email: Int-Admissions@broward.eduWebpage: www.broward.edu/international

International Student Admission Requirements

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CAREER PATHS:Arts, Humanities, Communication, & Design (AHCD)BusinessEducationHealth Science

Industry, Manufacturing, Construction & Transportation (IMC) Public SafetyScience, Technology, Math, & Engineering (STEM) Social Behavioral Sciences & Human Services (SBSHS)

Select Major Field Under Educational Objective

BACHELOR OF SCIENCE DEGREES (B.S.) (F-1 Visa Applicants Only)

2100 Accounting Technology 2509 Aviation Administration 2204 Aviation Maintenance Mgmt 2184 Building Construction Tech 2119 Business Administration 2508 Business Analytics 2506 Computer And Network Security 2149 Computer Information Tech 2195 Computer Programming And Analy 2149C Computer Systems Specialist 21102 Crime Scene 21101 Criminal Justice 2203 Culinary Arts Management 2215 Dental Assisting 2145 Dental Hygiene 2176 Diagnostic Medical Sonography 2216 Digital Media/Multimedia Tech

2166 Early Childhood Education 2160 Emergency Medical Services 2207 Engineering Technology 2182 Environmental Science Tech 2510 Film Production Technology 2118 Fire Science Technology 2192 Graphic Design 2179 Health Information Technology 21021 Hospital-Based Nuclear Med Tec 21591 Hospital-Based Rad Therapy 21311 Hospital-Based Radiography 2121 Hospitality & Tourism Mgmt 2194 Industrial Management Tech 2196 Internet Services Technology 2126 Marketing Management 2505 Medical Lab Technology 22112 Medical Office

2206 Music Technology 2503 Networking Systems Technology 2102 Nuclear Medicine Technology 2127 Nursing 21271 Nursing- Lpn To Rn Transition 22113 Office Management 2172 Paralegal Studies 2153 Physical Therapist Assistant 21104 Polygraph 2107 Professional Pilot Technology 2159 Radiation Therapy 2131 Radiography 2132 Respiratory Care 2191 Sports, Fitness, And Rec Mgmt 2205 Supply Chain Management Operat 2507 Technology Project Management 21891 Vision Care Tech/Opticianry

Complete 2 years of specialized training designed to allow you enter the workforce in a high-demand career with guaranteed job skills or continue your education by transferring to a Bachelor's program such as BC's BAS/BSN degrees or other articulated AS to Baccalaureate degree programs.

S600 Environmental Science Biosecurity S700 Environmental Science Physical Science S100 Exceptional Student Education Reading/Esol Endorsement K-12 S200 Middle Grades General Science Grades 5-9

S400 Middle Grades Mathematics Grades 5-9 S300 Secondary Biology Grades 6-12 S500 Secondary Mathematics Grades 6-12

BACHELOR OF APPLIED SCIENCE DEGREES (B.A.S.) (F-1 Visa Applicants Only)T300 Information Technology T100 Supervision And Management

T400 Supply Chain Management T200 Technology Management

N100 Nursing - Applicants must possess an Associate of Science in Nursing or higher from an accredited institution recognized by Broward College. Applicants must also possess an unrestricted and unencumbered active license as a registered nurse in the State of Florida.

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ASSOCIATE IN APPLIED SCIENCE DEGREE PROGRAMS (A.A.S.) (M-1 Visa Applicants Only)The Associate in Applied Science degree is a technical degree that prepares students for employment.

Students interested in an A.A.S. and/or certificate must first contact the Office of International Admissions at Int-Admissions@broward.edu to verify if the program is available to them. Not all A.A.S. nor certificates are eligible for the M-1 visa.

Students must complete an Associate's Degree or 60 college level credits prior to applying for the Bachelor's Degree Program.

BACHELOR OF SCIENCE IN NURSING DEGREES (B.S.N.) (F-1 Visa Applicants Only)

ASSOCIATE IN ARTS DEGREE PROGRAMS (A.A.) (F-1 Visa Applicants Only)

IEarn this degree and guarantee* transfer into one of the twelve Florida's four-year public universities. An Academic Advisor or Counselor will assist you to create your educational plan and receive additional university transfer information. *The guarantee does not apply to limited access or teacher certification programs or a major program requiring an audition.

ASSOCIATE IN SCIENCE DEGREE PROGRAMS (A.S.) (F-1 Visa Applicants Only)

Language Training Program (F-1 Visa Applicants Only)3005 Language Program (English as a Second Language)