Western Michigan University
International Student Application Form

NAME OF APPLICANT (as it appears on official documents)

________________________________________________________________________
Family Name _________________________________Given Name

U.S. Social Security Number (If available) _  _  _  - _  _  - _  _  _  _       

PERMANENT HOME COUNTRY ADDRESS (REQUIRED)

__________________________________________________________________________              (Number)                           ________          (Street)                                                         

__________________________________________________________________________                       _(City)                _______      (State/Province) ________ (Zip/Postal Code)  _____     (Country)

MAILING ADDRESS      

_________________________________________________________________________              (Number)                           ________          (Street)                                        

_________________________________________________________________________                       _(City)                _______      (State/Province) ________ (Zip/Postal Code)  _____     (Country)

Gender: _____ Male ___________Marital Status:______ Married__________ Fema _______ _____ Female ____________________________ Single       

CITIZENSHIP (Country): ________________________________

DATE OF BIRTH______________ City and Country of Birth _______________________
__________________Month/Day/Year__                         

PHONE #______________ FAX #______________ E-MAIL _______________________

Degree Applying for (mark one): ____ _____ Enrollment Date (Check one):

Bachelor's _________                          ______ ___ Fall (Sept.- Dec.)  20_ _
Master's _________                                          ___ Spring (Jan.- April)  20_ _
Doctorate _________                                       ___ Summer I (May - June)  20_ _ ______

U.S. VISA TYPE HELD   __________________    OR EXPECTED   _________________

SUBJECT I WANT TO STUDY (Programs list: international.wmich.edu/content/view/27/52/)

____________________________________________________________________________

OBJECTIVE TEST(S) YOU HAVE TAKEN OR PLAN TO TAKE  

TOEFL______ DATE_________
GMAT________ DATE__________
GRE _________ DATE__________
OTHER ENGLISH TESTS______________________ DATE__________

List below all secondary and post-secondary institutions you have attended or are attending:        Institution                                        Dates of Attendance           Degree/Diploma Received 

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

*Conditional Admission/English Proficiency: If I am eligible for a Western Michigan University program, but am unable to document the required English proficiency, please consider me for conditional admission and enrollment in CELCIS,  WMU's intensive English program.

Please Check:  

__ YES   Desired semester and year of CELCIS enrollment (Fall, Spring, Summer I/II):_______ __ NO    I do not wish to be considered for CELCIS enrollment.

*Student Certification:I certify that all information on this application is complete and accurate to the best of my knowledge. I have also read carefully the costs of enrollment and am prepared to meet these expenses.  Failure to report all institutions  attended will invalidate my application and may result in  dismissal if admitted.

Signature_________________________________________ Date______________________

Application fee (U.S. $100.00 non-refundeable) payment information 

__ YES, I am enclosing a check of U.S. $100.00 drawn on U.S. bank made payable to Western Michigan University.
__ YES, I authorize Western Michigan University to bill my credit card U.S. $100.00 for the application/document fee.

Credit Card Type  __ VISA       __ Mastercard         __ Discover
Account Number  __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 
Expiration Date  __ __ / __ __ __ __ (Month/Year)
3-Digit code  __ __ __ (found on back of card/signature panel)
Name on Card  __________________________________________
Signature  __________________________________________
_______________________________________________________________________________________
** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **

Western Michigan University

Statement of Finances for International Student

 

NAME OF APPLICANT (as it appears on official documents)

_____________________________________________________________________________
Family Name Given Name

U.S. Social Security Number (If available) _  _  _  - _  _  - _  _  _  _       

ADDRESS

__________________________________________________________________________
 (Number)  (Street)

__________________________________________________________________________
(City) (State/Province) (Zip/Postal Code)  (Country)

CITIZENSHIP (Country): ________________________________

Please provide proof that funding is available. Personal/family funds must be verified by a bank statement. If sponsored by your government, an official letter must be submitted showing that the scholarship is valid for use at WMU, indicating beginning and ending dates of validity.

Following is a list of estimated expenses which the typical student is expected to pay during each academic year of full-time enrollment (for 2006-2007 academic year, Eight months, 24-32 hours Undergraduate, 12 hours Graduate).

Cost Categories Undergraduate Undergraduate Graduate
Lower Division
(freshman/sophomore)		 Upper Division
(junior/senior)
Tuition & Fees
 $ 16,856.00* $ 18,686.00* $ 9,502.00*
Room & Board
    6,850.00    6,850.00   6,850.00
Books & Supplies
     906.00     906.00   1,482.00
Medical Insurance
       1,000.00    1,000.00    1,000.00
____________ ___________ ___________
TOTAL $25,612.00 $27,442.00 $18,834.00

  • The above figures are based on tuition and fees listed below. Tuition and fees are subject to change by the WMU Board of Trustees.

    • Undergraduate Lower Division (freshman/sophomore level classes) - $8,058 per semester(12-16 credits)
    • Undergraduate Upper Division (junior/senior level classes) - $8,973 per semester (12-16 credits)
    • Graduate - $730.18

Fees per semester*

  • International students are charged a $25 per semester/$12.50 per session fee
  • All students are charged an enrollment and student assessment fee of $345 per semester/$173 per session.
  • In addition, all students are charged a one-time records initiation fee of $300 upon entering WMU.
  • Room and board costs are approximately the same on and off campus.
  • The University requires that all students be covered by adequate medical insurance.
  • Additional $3,000 per spouse/child will be required if you plan to bring your dependent(s) to the U.S.
  • Personal/incidental fees are not included in the above costs.
  • Tuition and Fees are subject to change by the Western Michigan University Board of trustees.
  • Room and board costs are approximately the same on and off campus.
  • The University requires that all students be covered by adequate medical insurance.
  • Additional $3,000.00 per spouse/child will be required if you plan to bring your dependent(s) to the U.S.
  • For details on fees, please refer to Registrar's Office website at www.wmich.edu/registrar/tuition/index.htmll

Name of Sponsor (please print or type): _____________________________________________________

Relationship of Sponsor to Student: ____________________________________________________
If Funds Are Provided by an Organization, Give Name and Address of the Group:
______________________________________________________________________________________________



** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **
Western Michigan University
International Student and Dependent Information

 

SECTION 1 (Everyone must complete this section, even if you do not have dependents)

NAME OF WMU APPLICANT

________________________________________________________________________

Family Name ___

 

Given Name

 

Middle Name

 

U.S. Visa Type Held___________

U.S. Social Security Number (if Available)
Or Expected _________________ _________ - ______ - __________

CHECK ONE OF THE FOLLOWING:

  1. ___I do not have any F-2 or J-2 dependents (F-2 or J-2 visa holders) here in the U.S.
    (This section is complete. Please proceed to Section 3)
  2. ___I do have F-2 or J-2 dependents (F-2 or J-2 visa holders) here in the U.S.
    (Complete Section 2 and 3)
  3. ___I do have dependents that will be applying for an F-2 or J-2 visa to enter the
    U.S. (Complete Section 2 and 3)
  4. ___I do have dependents but they will not be applying for an F-2 or J-2 visa to
    enter the U.S. (Information is complete. Please proceed to Section 3)

SECTION 2

IF you have checked #2 or #3 above you MUST complete SECTION 2. If you have checked #1 or #4, skip this section and proceed to Section 3. Failure to provide this information will result in ineligibility for a U.S. VISA and/or lost of VISA benefits.

DEPENDENT #1 Information

________________________________________________________________________

Family Name ___

Given Name

Middle Name

DATE OF BIRTH(M/D/Y)_________________ GENDER _____ Female______ Male

COUNTRY OF BIRTH ____________ COUNTRY OF CITIZENSHIP__________

RELATIONSHIP WMU TO APPLICANT ___Spouse ___ Son ___ Daughter

U.S. VISA TYPE HELD _____ OR EXPECTED_____

 


DEPENDENT #2 Information

________________________________________________________________________

Family Name ___

Given Name

Middle Name

DATE OF BIRTH(M/D/Y))_________________ GENDER _____ Female______ Male

COUNTRY OF BIRTH ____________ COUNTRY OF CITIZENSHIP__________

RELATIONSHIP TO WMU APPLICANT ___Spouse ___ Son ___ Daughter

U.S. VISA TYPE HELD _____OR EXPECTED_____

DEPENDENT #3 Information

________________________________________________________________________

Family Name ___

Given Name

Middle Name

DATE OF BIRTH(M/D/Y)_________________ GENDER _____ Female______ Male

COUNTRY OF BIRTH ____________ COUNTRY OF CITIZENSHIP__________

RELATIONSHIP TO WMU APPLICANT ___Spouse ___ Son ___ Daughter

U.S. VISA TYPE HELD _____OR EXPECTED_____

DEPENDENT #4 Information

________________________________________________________________________
Family Name ___
Given Name
Middle Name

DATE OF BIRTH(M/D/Y)_________________ GENDER _____ Female______ Male

COUNTRY OF BIRTH ____________ COUNTRY OF CITIZENSHIP__________

RELATIONSHIP TO WMU APPLICANT ___Spouse ___ Son ___ Daughter

U.S. VISA TYPE HELD _____OR EXPECTED_____

**IF ADDITIONAL SPACE IS NEEDED PLEASE PROVIDE INFORMATION ON ANOTHER SHEET OF PAPER AND ATTACH TO THIS DOCUMENT**

SECTION 3 (Everyone must complete this section)

Student Certification: I certify that all information on this form is complete and accurate to the best of my knowledge.

Signature__________________________________________Date___________

 

Please return application to:
International Services and Student Affairs
4255 Ellsworth Hall
Western Michigan University
1903 W Michigan Ave
Kalamazoo, MI 49008-5246 U.S.A.

Phone: 269-387-5865   Fax: 269-387-5899   oiss.info@wmich.edu 

______________________________________________________________________________________________



** PLEASE KEEP A COPY OF THIS INFORMATION FOR YOUR RECORDS **