Visiting International Student Application

Surname or Family Name *

First Name or Given Name *

Middle Name

If your name appears differently on any other academic credentials, test scores, or other documents, please indicate that name below.

Official Name on your Passport *

Are you currently enrolled at another college or university in the U.S.? *

Yes

University or College Name

Date of Birth *

Month

Day

Year

City of Birth *

Country of Birth *

Country of Citizenship *

Country of Legal Permanent Residence *

Email Address *

Email Address 2

Parents Email Address *

Permanent

Permanent Address in Home Country *

Country *

Address 1 *

Address 2

Postal code

City *

Telephone Number *

Cell Phone Number

Current

Current Mailing Address

Country

Address 1 *

Address 2

Postal code

City *

(if different from permanent address)

Telephone Number *

Cell Phone Number

Name of Person to Contact in Case of Missing Person/Emergency

This can be your parent or guardian

First *

Middle

Last *

Relationship of Person Listed as Emergency Contact *

Emergency Address *

Country *

Address 1 *

Address 2

Postal code

City *

Telephone Number of Emergency Contact *

Cell Phone Number of Emergency Contact

Course Selections

Course Selections *

Course Selections

Which have you taken? *

TOEFL

IGCSE

IELTS

*TOEFL scores are required for all applicants whose native language is not English. IGCSE, IB, and IELTS scores are accepted. A high school diploma is required of all applicants.

What date did you take the TOEFL, IGCSE, IB, or IELTS? *

Month

Day

Year

I Affirm *

Yes

Date *

Month

Day

Year

I affirm that the information I have provided on this application form and all other admissions application materials is complete, accurate, and true to the best of my knowledge. Omitting or providing false information can lead to non-acceptance, the nullification of PSU credit, and/or dismissal. In addition, I understand that I am responsible for payment of all fees. I understand that it is my responsibility to check with my home institution regarding transferability of course credit. I also understand that admission to the Penn State's Summer Session for Visiting International Students program or participation in this program does not guarantee regular undergraduate admission to Penn State University. In consideration of my admission and enrollment, I, the undersigned, do hereby agree to assume and pay any and all costs and charges including interest, collection, and reasonable attorney's fees for delinquent accounts.