International Student Application Application Deadline Fall - May 31 Spring - October 31 APPLICANT INFORMATION Last/Family Surname: * First/Given Name: * Middle: Former Name (if any): Gender: * Male Female Date of Birth: * U.S. Social Security Number (if applicable): Email: * Telephone Number: * Street Address: * City/Town: * Province/State: Country: * Postal/Zip Code: Birthplace (Country): * Residency (Country): * Citizenship (Country): * Permanent Address in Country of Citizenship: * City/Town: * Province/State: Country: * Postal/Zip Code: Are you a U.S. citizen? * Yes No Type of nonimmigrant Visa being used or requested: * EMERGENCY CONTACT In case of emergency, contact: * Relationship to Applicant: * Email Address: * Telephone Number: * Current Mailing/Street Address: * City/Town: * Province/State: Country: * Postal/Zip Code ADMISSION INFORMATION Year of requested admission: * Term: * Fall Spring Major field of study: * Status: * New Student (Fewer than 12 credit hours) New Transfer Student (24 or more Returning Student (previously enrolled at Henderson State University) Do you plan to obtain a degree from Henderson State University? * Yes No Have you ever applied with Henderson State University? * Yes No If yes, did you enroll? Yes No Year Enrolled: Term Enrolled: Did you receive a degree? Yes No Has either of your parents attended at HSU? * Yes No If yes, list their names: Is English your native language? * Yes No If no, what is your native language? Have you taken the TOEFL/IELTS exam? * Yes No If yes, date exam was taken? TOEFL/IELTS Score TRANSFER INFORMATION (if you answered New Transfer Student for Status:) Name of College Attended: Dates Attended (From and To): Number of Credit Hours: Did you graduate? Yes No Degree Received: Are you eligible to return to school? Yes No Are you on probation or have you been suspended? Yes No Please explain ineligibility, if applicable: OPTIONAL INFORMATION How did your hear about Henderson State University? What influenced you to apply with Henderson State University?
