Application for International Students


Applying for (Check one term)

Fall Term- September through December
Winter Term- January through March
Spring Term- April through June
Summer Term- June through August

How did you hear about Mt. Hood Community College?

Agent Name: 

 

Please type your name as it appears on your Passport

First Name: Last Name:

Full Name:

Email:  

Birthday:

Month:Day:Year:

Country of Citizenship:

Country of Birth:

Telephone Number:

Permanent Address in Home Country

Number and Street - if available:

City: State or Province:

Country: Postal Code:

US Mailing Address

Number and Street:

City: State:

Postal Code:

Emergency Contact Information

First Name: Last Name:

Number and Street:

City: State or Province:

Country: Postal Code:

Email:

Telephone Number:

Relationship to You:

Visa Information

Are you currently in the US?

If yes, what is your current Visa status? (Ex. F-1, B-1/B-2)

If F-1, what institution are you attending now?

If B-1/B-2, what is your date of entry and expiration?

Passport Expiration Date:

Please list all previous schools attended:

Do you plan on bringing a dependent with you?

Do you plan to enroll in the High School Completion program?

What is your intended major?  

Upload supporting documents (optional - may submit via email)

 

Type your initials in the text box next to each statement below to indicate that you have read and understand each statement

I authorize the release of any information submitted by me in connection with my Mt. Hood Community College application for admission to any person, firm, corporation, association or government agency for the purposes of explanation or verification. This information includes but is not limited to: grades, attendance, number of credits registered for, and employment information
I certify that the information on this application form is true and correct. I have read and understand the MHCC guidelines and instructions regarding SEVIS. I know where to access current immigration regulations regarding F-1 student visa status. I understand that, if I am admitted to Mt. Hood Community College as an International Student, it is my responsibility to properly maintain my non-immigrant status and that I must complete 12 or more credits and maintain a minimum GPA of 2.0 each term in order to meet satisfactory academic progress and remain in status with the U.S. Citizenship and Immigration Services (CIS)
I acknowledge I am legally obligated to pay all charges incurred by registering as outlined under the MHCC Billing Collection Rights and Responsibilities which can be found at www.mhcc.edu/billing. I am also responsible for understanding and following college policies, administrative regulations, and procedures. Charges may include late fees, reimbursement for agency collection fees, attorney fees, and Oregon Department of Revenue charges for the collection of all delinquent debts owed to the college. By not paying all charges at the time they are incurred, I acknowledge that this debt is considered education debt/loan and that the educational debt is non-dischargeable under Section 523 (a) (8) of the US Bankruptcy Code. There is no statute of limitation on the collection of educational debt. To have course tuition/fee charges removed, I must process a drop or withdrawal on MyMHCC or through the Admissions, Registration and Records office within the refund period.

First Name: Date: