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International Student Admission Application

APPLICATION DEADLINE
Fall Semester: *June 1, **June 15 • Spring Semester: *October 1, **October 15 • Summer Session: * **April 1
*Out-of-USA Applicants | **Current F-1 Students in USA | APPLICATION MUST BE RECEIVED BY DEADLINE DATE. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
Term Applying For: Education Level:
o Summer o Fall o Spring 20__ __ o 0 – Not enrolled /did not graduate high school
o 1 – Enrolling in high school and college
o English Language Training o 3 – Received High School Diploma
o Academic Program o 4 – GED/H.S. Equivalency Certificate
o 6 – Foreign Secondary School Diploma

Full Legal Name: (As it appears in your passport) o 7 – Associate Degree

o 8 – Bachelor Degree or higher
Last Name __________________________________________________
Program of Study/Major at SBCC ______________________________
First Name __________________________________________________
o English Language Training
Middle Name ________________________________________________
Citizenship:
Previous Name on Academic Records: (Full Legal Name) o 5 – Student Visa (F-1)

___________________________________________________________ o 6 – Other Visa (Specify)____________________ Date Issued______________

o 8 – Student Visa (M-1)
o No Visa (Residing Outside of U.S.)
Personal Information: (Verification of Visa status is required. Students must be prepared to present proof
Social Security Number: ___ ___ ___-___ ___-___ ___ ___ ___ of status.)
(If none, leave blank) Country of Birth _____________________________________________

Date of Birth (MM/DD/YYYY) ___________________________________ Country of Citizenship _________________________________________

Gender M o F o Race/Ethnicity:
Student’s Email Address _______________________________________ Are you Hispanic or Latino? oYes oNo
What is your race/ethnicity? Check one or more.
U.S. Mailing Address: (Complete only if you live at this address) o 01 Hispanic, Latino o 12 Asian Vietnamese
Street Address _______________________________________________ o 02 Mexican, Mexican-American, Chicano o 13 Filipino
o 03 Central American o 14 Asian Other
City ________________________________________________________ o 04 South American o 15 Black or African American
State __________________________Zip/Postal Code ______________ o 05 Hispanic Other o 16 American Indian/Alaskan Native
o 06 Asian Indian o 17 Pacific Islander Guamanian
Country if other than U.S. ______________________________________ o 07 Asian Chinese o 18 Pacific Islander Hawaiian
Telephone Number ( )______________________________________ o 08 Asian Japanese o 19 Pacific Islander Samoan
o 09 Asian Korean o 20 Pacific Islander Other
Permanent Home Country Address:
o 10 Asian Laotian o 21 White
o 11 Asian Cambodian o 22 Other
o Check here if same as mailing address

No/Street Address ____________________________________________ High School Last Attended

City ________________________________________________________ High School Name ____________________________________________
State/Province __________________Zip/Postal Code ______________ City ____________________________State/Province________________
Country_____________________________________________________ Country if other than U.S. ______________________________________
Telephone Number ( )______________________________________ Graduation Date (MM/DD/YYYY)_________________________________
Fax Number ( ) ___________________________________________
Prior College(s)/Language Schools: List most recent first.
Student Type: College Name________________________________________________
o 1 New (Never attended any college before, or attended while in high school
or U.S. language school, but not SBCC) City ____________________________State/Province________________
o 2 New Transfer (Attended U.S. college or completed BA/MA degree) Country if other than U.S. ______________________________________
o 3 Returning Transfer (Attended SBCC, but last attended another college)
o 3 Returning (Last attended SBCC, but not last semester) From (MM/DD/YYYY) ______________To (MM/DD/YYYY) ____________
Degree Earned (if applicable) ___________________________________
Education Goal:
o A Transfer with AA/AS Degree Prior College:
o B Transfer without AA/AS Degree College Name________________________________________________
o C Associate Degree without Transfer
City ____________________________State/Province________________
o K Basic Skills/English, Reading, Math
Country if other than U.S. ______________________________________
From (MM/DD/YYYY) ______________To (MM/DD/YYYY) ____________
Degree Earned (if applicable) ___________________________________
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Parent/Guardian Information 1: Foundation for SBCC:

I am interested in learning about the Foundation for SBCC and ways
Last Name __________________________________________________
to support SBCC and its students. I give consent to release my name,
First Name __________________________________________________ mailing address and email addresses for this purpose.
Relationship: o Father o Mother o Guardian o Yes o No
o Check here if same as permanent address.
Street Address _______________________________________________
City ________________________________________________________
State __________________________Zip/Postal Code ______________
Country if other than U.S. ______________________________________
Telephone Number ( )( ) ________________________________

Parent/Guardian Information 2:
Last Name __________________________________________________
First Name __________________________________________________
Relationship: o Father o Mother o Guardian
o Check here if same as Parent / Guardian #1 address
Street Address _______________________________________________
City ________________________________________________________
State __________________________Zip/Postal Code ______________
Country if other than U.S. ______________________________________
Telephone Number ( )( ) ________________________________

Primary Language:
o 01 – English o 05 – Spanish
o 02 – Chinese o 06 – Vietnamese
o 03 – Farsi o 07 – Other
o 04 – Japanese
Transfer Plans:
o 00 – No Transfer Plans
o 01 – Out of State/ Foreign o 11 – Community college
o 02 – UCSB o 12 – CSU, Channel Islands
o 03 – UC Berkeley o 13 – UC Davis
o 04 – UCLA o 14 – UC Irvine
o 05 – Other UC campuses o 15 – UC San Diego
o 06 – Cal Poly, SLO o 16 – UC Santa Cruz
o 07 – CSU, Northridge o 17 – San Diego State
o 08 – Other CSU campuses o 18 – CSU, Long Beach
o 09 – Westmont College o 19 – San Francisco State
o 10 – CA private college o 20 – USC
To Be Signed by all Students
I declare under penalty of perjury that the statements submitted by me are
true and correct. All materials submitted by me for the purposes of admis-
sion become the property of Santa Barbara City College. I understand
that falsification, withholding pertinent data, or failure to report change in
residence may result in my dismissal.

Students Signature ____________________________Date ___________

Mail to:
International Student Support Program
For Office use only
Banner I.D.: K __________________________
Santa Barbara City College
721 Cliff Drive, Santa Barbara, CA 93109-2394 USA
Residency: o 5 – CA o 6 – OS o 8 – INTL
Phone (805) 730-4040
o 7 – AB540 o 9 – F – 1 VISA
Fax (805) 965-0781
Entered by: ____________________________ Date: ______________________

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