Admission Application for International Students

Admission Application for International Students
- 1. Name as they appear on your passport*
  
  First (Given Name)Middle NameLast Name (Family Name)
- 2. U.S. Phone Number (if available)
  Please enter a valid phone number.
- 3. Outside U.S. Phone Number (if available)
  
  Country CodeArea CodePhone Number
- 4. Email*
  example@my.pbsc.edu
- 5. Gender*
  
  MaleFemaleI do not wish to disclose
- 6. Current Immigration Status*
- Other (Please Specify):*
- 7. Intended Immigration Status*
  
  F-1
- 8. United States Address (if available)
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- 9. Address Outside United States (if available)
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip CodeCountry
- 10. Permanent Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- 11. Country of Birth*
- 12. Date of Birth*
  
  MonthDayYear
- 1. Intended Semester of Enrollment*
  
  FallSpringSummer
- 2. Intended Year of Enrollment*
- 3. Enrollment Status*
  
  First Year (Please select this field if this is going to be the first time you will attend any type of college or university)Transfer (Please select this field if you have attended any college or university other than Palm Beach State College)Returning/Readmission (Please select this field if you have previously attended Palm Beach State College)
- PBSC Student ID
- 10. Country of Citizenship
- 4. Program Objective*
  
  Associate in Arts (A.A.)Associate in Science (A.S.)Bachelor of Applied Science (B.A.S.)
- Associate in Arts (A.A.)*
  
  Arts, Communication, Design & HumanitiesEducation, Human Services, Social & Behavioral ScienceIndustry, Manufacturing, Construction & TransportationScience, Technology, Engineering & Math (STEM)BusinessHealth SciencesPublic Safety
- Associate in Science (A.S.)*
- International applicants are only eligible for admissions in BAS Supervision and Management (General Management and Health Management concentrations)
- Which concentration do you intend to choose?*
  
  General ManagementHealth Management
- 5. Preferred Campus Location
  
  Belle GladeBoca RatonLake WorthLoxahatchee GrovesPalm Beach Gardens
- Please note: Submission of original high school diploma will be required.
- 1. Secondary/High School Name*
- 2. Country of Secondary/High School*
- 3. Secondary/High School Graduation Date*
  
  MonthDayYear
- 4. Primary Language of Secondary/High School instruction:*
  What language were most of your high school classes taught in?
- 2. Country of Secondary/High School*
- Submission of all transcript(s) and commercial evaluation(s) may be required.
- 1. List all College/University institutions you have attended
Should be Empty: