International
Undergraduate Admissions Application
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Identification: |
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| What other names are you known by?
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| Mailing Address: |
| Street: |
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| Residence Information: |
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| Alien Registration Number (if applicable):
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| Date of Issuance:
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| International Address:
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| Contact Information: |
| Email Address:
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| Home Phone:
Work
Phone: |
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| Demographic Data: |
| Race (optional):
For Federal/State reporting purposes only. This information
will be used in a non-discriminatory manner consistent with civil
rights laws. |
| Birthplace: |
| City:
State:
Country:
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| Parent/Guardian Information: |
| Parent or Guardian:
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| Parent/Guardian Name:
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| Parent/Guardian Street Address:
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| Education: |
| Have you taken the TOEFL?
Date you are taking the TOEFL:
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| Name of Secondary School Last Attended:
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| School Street Address:
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| Secondary Education Level:
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| Date Received:
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| Enrollment Date:
Year:
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| Are you seeking a degree at SAUM?
Specify Major:
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| If no, are you seeking teaching certification?
Recertification?
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Are you presently on
from any college or university?
If so, please explain in detail below:
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| Disciplinary (information required): |
| Have you ever been convicted, pleaded guilty, or are you
presently charged by indictment or information with a crime (a
felony) which might be punishable by imprisonment in a
penitentiary? |
| Have you ever been committed to a correctional or training
institution?
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If the answer to either question is "yes", give details
including date, name of court, nature of offense, status of
charge, penalty imposed, if any, or other disposition:
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| Classification: |
Do you plan to live on campus?
Did your parents attend SAUM?
New first-time student -- No previous college/university work.
Returning student -- Previously attended SAU, Magnolia, but was
not enrolled the previous semester.
Transfer student -- Never enrolled at SAU, Magnolia, but have
been enrolled in other colleges/universities.
Transient student -- Currently seeking a degree at another
institution.
Non-degree seeking (but enrolling for professional
development/personal interest) |
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| Transfer Students Only |
| Please list all colleges/universities, including SAU-Tech,
you have attended. Include colleges/universities at which you
have officially registered even though you may not have attended
classes. Failure to list all colleges/universities could result
in dismissal from SAUM. |
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I affirm that the information which I have provided on this
application form and all other admission material is complete,
accurate, and true. I authorize each high school and each
college, university, or school I have attended or agency from
which I have received education credentials to release academic
and personal information as related to this admission
application upon request by Southern Arkansas University,
Magnolia (SAU).
I agree to submit other materials which are required for this
admission application and understand that failure to do so and
/or the furnishing of false, incomplete, or misleading
information in connection with my admission or attendance at
Southern Arkansas University, Magnolia may at any time result in
the termination of my admission and registration at SAUM.
I agree that as a student I am subject to the Southern
Arkansas University, Magnolia Code of Student Conduct.
I agree that directory information as defined by the Family
Educational Rights and Privacy Act will be available to the
general public unless I notify the vice president for student
affairs no later than the end of registration week each semester
or term that all or part of the directory information should not
be released without prior consent. Directory information means
information contained in an education record of a student that
would not generally be considered harmful or an invasion of
privacy if disclosed. It includes, but is not limited to, the
student's name, address, telephone listing, electronic mail
address, photograph, date and place of birth, major field of
study, dates of attendance, grade level, enrollment status
(e.g., undergraduate or graduate; full-time or part-time),
activities and sports, weight and height of members of athletic
teams, degrees, honors and awards received, and the most recent
educational agency or institution attended.
By submitting this information to Southern Arkansas
University you are agreeing to the above statement.
Southern Arkansas University, Magnolia is committed to the
policy of providing educational opportunities to all qualified
students regadless of their economic or social status, and will
not discriminate on the basis of race, age, color, sex,
disability, or national origin. |
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International Student Office
Southern Arkansas University
P.O. Box 9224
Magnolia, Ar 71754-9224
Telephone: 870-235-4082
Fax: 870-235-5096
Southern Arkansas University, Magnolia, is
committed to the policy of providing educational opportunities
to all qualified students regardless of their economic or social
status, and will not discriminate on the basis of race, age,
color, sex, disability, or national origin. |
