Authority:
Non US citizens (aliens) are subject to the same considerations as US citizens in the determination of residency status for tuition purposes unless:
- A. The alien abides in the United States under a visa conditioned at least in part upon intent not to abandon a foreign domicile (B, F, J, P, Q and S visas); or
- If an alien has a visa and physically surrenders it to immigration authorities, he or she is still deemed to be abiding in the United States under that visa until immigration authorities issue another document.
Directions for Completing the Application:
- Print or type your response to each question. Important: Be completely accurate to the best of your knowledge and understanding; knowingly falsifying your responses may subject you to disciplinary action including dismissal from the institution.
- Sign and date this application where indicated to those acknowledgements and certifications necessary to render this a viable application. Important: If you do not sign the application, it will be returned to you.
- Attach a copy of all relevant documentation
- Make a copy of your entire application to keep for your records.
SECTION 1
Applicant Information
Applicant’s Full Name: / ,
Last Name / First Name / Middle Name
Previous or Maiden Name:
Student ID #: / SSN (last four): / ###-##- / No SSN:
Date of Birth: / Click to choose date. / Age:
University Assigned Email Address:
Daytime Phone: / () / Is this a cell phone: / Yes / No
Evening Phone: / () / Is this a cell phone: / Yes / No
Current Mailing Address (If written communication is required concerning this petition, it will be sent to this address.)
Addr Line 1:
Addr Line 2:
City: / State: / Zip: / -
If non US Address
Providence/Country:
From: / Click to choose date. / To: / Click to choose date. /
Permanent Mailing Address
Addr Line 1:
Addr Line 2:
City: / State: / Zip: / -
If non US Address
Providence/Country:
From: / Click to choose date. / To: / Click to choose date. /
Application Term & Enrollment Information
This application applies to which term(semester & year):
Term which you began this institution(semester & year):
Are you enrolled at this institution for the current or future term? / Yes / No
Visa Information of Applicant
- Do you possess a valid current visa:
- What is the designation of your visa (this is NOT the same as your alien number)?
(S, R, Q, P, O, N, M, L, K,.J, I, H, G, F, E, D, C, B, A, TN, or TC plus a one-digit number. Example: J-2, B-1, etc.)
- What date was your visa issued:
- What date does your visa expire:
- Have you filed for permanent resident status with immigration?:
- Do you posses a valid, current Form I-551 or I-551 (Alien Registration Receipt Card)? Yes No
If yes, what is the registration number?
This document reflects your lawful admission into the U.S. for permanent residence as an immigrant on what date? / Click to choose date.
- Do you possess a valid, current Form I-181 (memorandum of Creation of Record of Lawful Permanent Residence: Yes No
If yes, it reflects your lawful admission into the U.S. for permanent residence as an immigrant on what date?
Click to choose date. /
- Immediately before you received your Form I-151, I-551, or I-181, did you possess a valid, current visa? Yes No
What was the letter determination of the visa?
When was the visa issued? / Click to choose date. /
- Do you possess a valid current Parole Edition Form I-94 (Arrival-Departure Record)?
Was this an immigrant visa? / Yes / No
What is the letter designation of the visa?
When was the visa issued? / Click to choose date. /
- Are you a refugee?
If so, do you possess a valid, current Form I-94 which shows you were admitted as a
refugee pursuant to Section 207 (A) of the Immigration and Nationality Act? Yes No
What is the date of admission on that form? / Click to choose date. /
- If you posses none of the above documents, what documents do you have which allows you to abide in the United States?
(Attach a copy of the document if permitted by immigration law. If not, be prepared to display the document for inspection upon request.) Thank You.
Acknowledgements and Certification:
- I hereby certify that, to the best of my knowledge and belief, all information I have set forth herein is true and accurate.
- I understand and agree that the institution may verify information with regard to this application.
- I understand that the institution may divulge the contents of this application only as permitted under state laws and/or under the Family Educational Rights and Privacy Act of 1974 if I am, or have been, in attendance at this institution.
- I understand that knowing falsification of this application may result in revocation of my admission and/or a violation under the institution’s code of conduct.
Applicant’s Signature / Date
Section 2 Parent(s) or Spouse complete the following if NOT a U.S. Citizen
Parent/Spouse Information
Full Name: / ,
Last Name / First Name / Middle Name
Previous or Maiden Name:
Student ID #: / SSN (last four): / ###-##- / No SSN:
Date of Birth: / Click to choose date. / Age:
Relationship: / Parent / Spouse
Daytime Phone: / () / Is this a cell phone: / Yes / No
Evening Phone: / () / Is this a cell phone: / Yes / No
Current Mailing Address
Addr Line 1:
Addr Line 2:
City: / State: / Zip: / -
If non US Address
Providence/Country:
From: / Click to choose date. / To: / Click to choose date. /
Permanent Mailing Address
Addr Line 1:
Addr Line 2:
City: / State: / Zip: / -
If non US Address
Providence/Country:
From: / Click to choose date. / To: / Click to choose date. /
Parent/Spouse Visa Information (
- Do you possess a valid current visa:
- What is the designation of your visa (this is NOT the same as your alien number)?
(S, R, Q, P, O, N, M, L, K,.J, I, H, G, F, E, D, C, B, A, TN, or TC plus a one-digit number. Example: J-2, B-1, etc.)
- What date was your visa issued:
- What date does your visa expire:
- Have you filed for permanent resident status with immigration?:
- Do you posses a valid, current Form I-551 or I-551 (Alien Registration Receipt Card)?
If yes, what is the registration number?
This document reflects your lawful admission into the U.S. for permanent residence as an immigrant on what date?
Click to choose date. /
- Do you possess a valid, current Form I-181 (memorandum of Creation of Record of Lawful Permanent Residence: Yes No
If yes, it reflects your lawful admission into the U.S. for permanent residence as an immigrant on what date?
Click to choose date. / Day / Year
- Immediately before you received your Form I-151, I-551, or I-181, did you possess a valid, current visa?
What was the letter determination of the visa?
When was the visa issued? / Click to choose date. /
- Do you possess a valid current Parole Edition Form I-94 (Arrival-Departure Record)?
Was this an immigrant visa? / Yes / No
What is the letter designation of the visa?
When was the visa issued? / Click to choose date. /
- Are you a refugee?
If so, do you possess a valid, current Form I-94 which shows you were admitted
as a refugee pursuant to Section 207 (A) of the Immigration and Nationality Act? Yes No
What is the date of admission on that form? / Click to choose date. /
- If you posses none of the above documents, what documents do you have which allows you to abide in the United States?
(Attach a copy of the document if permitted by immigration law. If not, be prepared to display the document for inspection upon request.) Thank You.
Acknowledgements and Certification:
- I hereby certify that, to the best of my knowledge and belief, all information I have set forth herein is true and accurate.
- I understand and agree that the institution may verify information with regard to this application.
- I understand that the institution may divulge the contents of this application only as permitted under state laws and/or under the Family Educational Rights and Privacy Act of 1974 if I am, or have been, in attendance at this institution.
- I understand that knowing falsification of this application may result in revocation of my admission and/or a violation under the institution’s code of conduct.
Parent/Spouse Signature / Date
Submit to:
New Undergraduate Students / Continuing Undergraduate Students / New & Continuing Graduate Students
Office of Admissions
102 Cordelia Camp Building
Cullowhee, NC 28723
(828) 227-7317 / Registrar's Office
206 Killian Annex
Cullowhee, NC 28723
(828) 227-7216 / Graduate School
110 Cordelia Camp Building
Cullowhee, NC 28723
(828) 227-7398
Non US Citizens; Supplemental DataPage 1 of 511/22/2010