application for international undergraduate admission

Office of Admissions • 119 Anderson Hall • Manhattan, KS 66506
Phone (785) 532-6250 • Fax (785) 532-6393
E-mail: k-state@k-state.edu
NAME _____________________________________________________________ GENDER Male Female
Last/Family (As it appears on passport) First/Given Middle
OTHER NAME(S) THAT MAY APPEAR ON YOUR ACADEMIC RECORDS________________________________________________________
Last/Family First/Given Middle
DATE OF BIRTH ______/_______/_________ CITY OF BIRTH ________________________________________
Month/Day/Year
COUNTRY OF BIRTH ________________________COUNTRY OF CITIZENSHIP __________________________
E-MAIL ADDRESS ________________________________ TELEPHONE NUMBER ________________________
Updates on your application status are sent here REQUIRED Country code/City code/Number
PERMANENT INTERNATIONAL ADDRESS: REQUIRED for immigration purposes
_____________________________________________________________________________________________
Number and Street Address
_____________________________________________________________________________________________________________________
City State or Province Postal Code Country
MAILING ADDRESS: Your admission packet will be sent by FedEx to this address—NO P.O. BOXES
_____________________________________________________________________________________________
Number and Street Address
_____________________________________________________________________________________________________________________
City State or Province Postal Code Country
EMERGENCY CONTACT INFORMATION ___________________________________________________________
Name
Relationship to Applicant
_____________________________________________________________________________________________________________________
Street Address City State or Province Postal Code Country
_____________________________________________________________________________________________________________________
Telephone Number
E-mail Address
PLANNED DATE OF ENTRY Fall (August) _______ Spring (January) ________ Summer (June) ________
Year Year Year
PROGRAM OF STUDY YOU WANT TO MAJOR IN ______________________________________
For more information about majors, please visit: http://consider.k-state.edu/majorslist/majorslist.htm
VISA TYPE CURRENTLY HELD (If applicable) __________ VISA TYPE REQUESTED F1 J1 Not requesting a visa
(Circle one)
ENGLISH IS MY PRIMARY LANGUAGE Yes No
MY PRIMARY LANGUAGE IS _____________________
ONE OR BOTH OF MY PARENTS RECEIVED A FOUR-YEAR COLLEGE DEGREE Yes No
ONE OR BOTH OF MY PARENTS GRADUATED FROM K-STATE Yes No
ARE YOU HISPANIC OR LATINO? Yes No
WHAT IS YOUR RACE? SELECT ONE OR MORE American Indian or Alaska Native Asian
Black or African American Native Hawaiian or Pacific Islander White
For definitions of these race and ethnicity categories, please visit: http://nces.ed.gov/ipeds/glossary/