Part ll -Sponsor - Anne Arundel Community College
Part ll -Sponsor - Anne Arundel Community College
Part ll -Sponsor - Anne Arundel Community College
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
101 Co<strong>ll</strong>ege Parkway, Arnold, MD 21012<br />
Admissions and Enro<strong>ll</strong>ment Development, SSVC 100 Tel 410-777-2677 Fax 410-777-4831 www.aacc.edu<br />
Change of Non-Immigrant Status To F-1 Student Status<br />
Changing your lawful non-immigrant status is a serious matter. The procedures outlined below are merely suggestions. The<br />
change of status application is your application, signed by you. You may wish to consult an immigration attorney to assist you,<br />
though not required. It is your responsibility to make sure you are in compliance with your current immigration status.<br />
Most non-immigrants are eligible to request a change to F-1 (student) status if they have maintained their current, lawful<br />
status. Individuals in J-1 status who are subject to the two-year home residence requirement (Section 212e) are not eligible<br />
for a change of status unless a waiver is granted by the United States Citizenship & Immigration Services (USCIS). The<br />
approval of a change of status can take up to 7-8 weeks or more for USCIS to process. Students must submit the documents<br />
listed below to AACC in order to get the I-20 form or Certificate of Eligibility.<br />
<strong>Part</strong> 1 - Submission of these documents to AACC is the first part of the process in order to receive an I-20<br />
Or Certificate of Eligibility form. You must contact the DSO or International Student Advisor in<br />
Admissions office, Emma B. Thompson at 410-777-2677 to schedule an appointment. Make sure<br />
to bring a<strong>ll</strong> documents required on the day of your appointment.<br />
� Completed <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege International ( F-1) Student Admission Application Form<br />
� Official or certified copies of transcripts from secondary and post secondary with English translation. If you attended<br />
another school in the United States, you must submit an official transcript from that school.<br />
� Official TOEFL score or AACC English placement test . Minimum TOEFL score of 550 paper-based, 213 computer-<br />
based and 79 internet-based test wi<strong>ll</strong> be admitted to Associate degree program. AACC TOEFL code is 5019.<br />
� Financial Documentations (not more than 3 months old).<br />
o Two (2) original bank statements or official letter from the bank on a letterhead in English and in US<br />
currency for at least $ 25,944 for one academic year’s expenses. Additional $5000 per dependent.<br />
o If a sponsor supports you, submit their original bank statement or official bank letter with<br />
o Affidavit of support or Form I-134 if your sponsor is living in the U.S. Form I-134 is available online at<br />
http://uscis.gov.<br />
� Photocopies of passport page, I-194 (front and back), visa page and DS 2019 if currently holding a J1 visa.<br />
SEVIS FEE<br />
After receiving Form I-20 from the co<strong>ll</strong>ege, student must pay SEVIS fee of $200 (www.fmjfee.com) online with credit<br />
card or ATM cards drawn in the U.S. bank and print the receipt . You must include proof of SEVIS fee receipt in your<br />
application packet.<br />
Deadlines: June1 st for Fa<strong>ll</strong> (August) enro<strong>ll</strong>ment<br />
Nov. 1 st for Spring (January) enro<strong>ll</strong>ment
<strong>Part</strong> 11 - Mail the fo<strong>ll</strong>owing documents to U.S. Citizenship and Immigration Services (USCIS)<br />
� Completed Form I-539 (Application to Extend/Change Non-immigrant Status). You can obtain the form at<br />
http://uscis.gov<br />
� Check or Money Order of $ 290 USD payable to U.S. Department of Homeland Security.<br />
� Financial documentations (same as above requirements)<br />
� Photocopies of passport page, I-94 (front and back), visa page and DS 2019 if currently holding a J1 visa.<br />
� Original current I-20.( signed by student and DSO)<br />
� Payment receipt of the $200 SEVIS fee<br />
� Personal letter requesting change of status (see attached example letter)<br />
a) Explain the intent of your original entry<br />
b) Explain how and when you decided to go to school and apply for a change of status<br />
c) Explain your academic and professional plans.<br />
Highest degree you plan to earn, field of study, why it is better to study in the US rather than in your<br />
home country (establish your intent to return home)<br />
d) Explain your intent to return home, including your permanent resident address.<br />
Supporting letters and additional evidence may be helpful.<br />
Mail the entire application packet to: (It is recommended to mail thru Express Mail with receipt and tracking number)<br />
U.S. Citizenship and Immigration Services (USCIS)<br />
ATTN: I-539<br />
2501 S. State Highway 121 Business<br />
Suite 400<br />
Lewisvi<strong>ll</strong>e, TX 75067
Example of Personal Letter Format for<br />
Change of Status to F-1<br />
February 21, 2005<br />
USCIS Vermont Service Center<br />
75 Lower Welden Street<br />
St. Albans, VT 05479-0001<br />
Dear Examiner,<br />
Maria Sample<br />
2014 Park Rd.<br />
Arnold, MD 04473<br />
Please change my status from F-2 dependent (or other status) to F-1 student status.<br />
(Explain why you did not enter the US in the F-1 status that you now seek)<br />
(Explain how long you have bee engaging in the activities for which you were<br />
admitted to the US by the Department of Homeland Security)<br />
(State/Say that after you entered the US, you decided to attend school. What<br />
information or other factors led you to make that decision)<br />
(Explain where you wi<strong>ll</strong> go home to live after you finished studying in the US)<br />
(Explain how your course of study wi<strong>ll</strong> help you academica<strong>ll</strong>y or professiona<strong>ll</strong>y after<br />
you leave the USA.<br />
Thank you for your kind consideration of my application.<br />
Sincerely,<br />
Your Signature<br />
Name (Print)
TOEFL SCORE INFORMATION<br />
Requirements for <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege<br />
Admission to Associate degree program/Regular Status: ENG 115<br />
550 Written equivalence<br />
213 Computer equivalence<br />
79 Internet-based equivalence<br />
Admission to Intermediate and Advanced Level in ESL<br />
450 Written equivalence<br />
133 Computer equivalence<br />
45 Internet-based equivalence<br />
Admission to Beginning ESL program<br />
435 Written equivalence<br />
123 Computer equivalence<br />
41 Internet-based equivalent<br />
For information about test dates, locations, forms and registrations, go to website:<br />
http://www.toefl.org<br />
TOEFL/TSE SERVICES<br />
PRINCETON<br />
P.O. BOX 6151<br />
PRINCETON, NJ 08541-62151<br />
Email: toefl@ets.org<br />
Exceptions are made for the students who submit one of the fo<strong>ll</strong>owing:<br />
o <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege Placement test<br />
o Transfer of co<strong>ll</strong>ege English credit from an accredited U.S. agencies, co<strong>ll</strong>ege and universities.<br />
o Completion of AACC’s ESL program<br />
o SAT Scores in Reading 510 or above<br />
o ACT Scores in Reading 18 or above<br />
o If you are a national of the English speaking countries like Australia, Canada (except Quebec), Caribbean,<br />
Ireland, United Kingdom and New Zealand etc.<br />
AACC TOEFL CODE - 5019
101 Co<strong>ll</strong>ege Parkway, Arnold, MD 21012<br />
Enro<strong>ll</strong>ment Development and Admissions Tel. 410-777-2677 Fax 410-777-4831<br />
<strong>Part</strong> I - APPLICANT<br />
______________________________________ ______________________________ ____________<br />
Family (Last Name) as it appears on your passport Given (First) Name Middle Name<br />
____________________________________ ______________________________ ____________<br />
Country of Citizenship Country of Birth Date of Birth<br />
I Plan to come to the U.S. with qualifying dependents (qualifying dependents are a spouse and/or children)<br />
Name of Dependents Date of Birth Country of Birth Country of Citizenship Relationship<br />
Estimated annual expenses for study at <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege:<br />
Tuition and Fees………………………………………..… $11,190<br />
(based on 15 credit hours/$330per credit hour + fees)<br />
Books and supplies ………………………………………….$1,517<br />
Living and Incidental Expenses………………………….$13,237<br />
Room and Board $9,000<br />
Transportation $2,437<br />
Personal Expenses $1,800<br />
Total………………………………………………………$25,944<br />
Complete line 1, 2, 3, & 4 below indicating the specific source or sources and exact amount available to cover for one academic year of<br />
study. You must provide documented evidence such as Official bank statements and/or letter from the bank (not more than 3 months<br />
old) documenting available funds in US do<strong>ll</strong>ars for at least $25,944. If supported by a sponsor, he/she must submit an affidavit of<br />
financial support or Form I-134 and notarized stating the type of support to be provided. Form I-134 can be obtained at the Admissions<br />
office or at http://uscis.gov. Add $5000 per dependent. Investment portfolios, mortgage appraisals, and similar statements are not<br />
acceptable. Note: Please request additional set of original financial documents to prove to the United States Consular and USCIS<br />
officials upon entry to the U.S., that you have sufficient funds.<br />
Important Note: <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege DOES NOT provide housing for students. A<strong>ll</strong> co<strong>ll</strong>ege students are responsible for<br />
their own room and board.<br />
U.S. Do<strong>ll</strong>ars<br />
1. Personal funds of student $_________________________<br />
2. Family funds from abroad $_________________________<br />
3. Funds from other sources $_________________________<br />
4. Support by sponsor $_________________________<br />
Total: (Must total $25,944) $__________________________<br />
STATEMENT OF FINANCIAL<br />
RESOURCES FORM<br />
This form is to certify that you wi<strong>ll</strong> have the estimated sum to cover your educational plus living and incidental expenses for each and every<br />
year of study at <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege. Financial documentations must be attached to this form. A form I-20 (Certificate of<br />
Eligibility) cannot be issued to you until you have been academica<strong>ll</strong>y and financia<strong>ll</strong>y admitted to the co<strong>ll</strong>ege.
Student Name_______________________________________________________<br />
<strong>Part</strong> <strong>ll</strong> -<strong>Sponsor</strong><br />
List of financial documentations attached:<br />
______________________________________________________<br />
______________________________________________________<br />
______________________________________________________<br />
______________________________________________________<br />
______________________________________________________<br />
This is to certify that I, the undersigned, have agreed to provide the funds indicated above to the applicant for<br />
the purpose of fu<strong>ll</strong>-time study at <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege including living and incidental expenses while in<br />
the United States ,and that I am submitting the required verification indicating the availability of these funds.<br />
___________________________________ __________________ ________________<br />
<strong>Sponsor</strong>’s Family (Last) Name Given (First) Name Middle Name<br />
_____________________________________________________________________________<br />
Address<br />
__________________________________ _________________________<br />
<strong>Sponsor</strong>’s Signature/date Telephone<br />
This is to certify that the information given on this form is complete and accurate to the best of my knowledge. I am fu<strong>ll</strong>y aware<br />
that false or misleading statements wi<strong>ll</strong> result in an automatic denial of admission.<br />
______________________________________________________<br />
Applicant’s Signature/date<br />
Please return completed forms and supporting documents to:<br />
Emma B. Thompson<br />
International Enro<strong>ll</strong>ment Specialist<br />
<strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege<br />
Enro<strong>ll</strong>ment Development and Admissions, SSVC 100<br />
101 Co<strong>ll</strong>ege Parkway<br />
Arnold MD 21012<br />
USA
Applicants: Please read the statement and sign below.<br />
Change of Status Request Statement<br />
With certain exceptions, an alien already in the United States in non-immigrant status may apply for a change of<br />
status to F-1 status. The USCIS determines eligibility for a change of status in general. The co<strong>ll</strong>ege merely<br />
admits the student to an appropriate program based on academic eligibility and guaranteed financial ability to<br />
pursue the intended course of study.<br />
Genera<strong>ll</strong>y, non-immigrants who have filed a timely application for a change of status to a different non-immigrant<br />
status or have filed an application for extension of stay can remain in the United States while their application is<br />
pending. This assumes that the applicant was in valid non-immigrant status when he/she filed the application,<br />
and that the current non-immigrant status of application wi<strong>ll</strong> continue to be valid up to the date that the new status<br />
is requested to begin.<br />
Please be aware that there is no guarantee that USCIS wi<strong>ll</strong> agree to change your status. If USCIS should<br />
deny your request to change status, you wi<strong>ll</strong> be required to return to your country right away if your<br />
current visa status has expired.<br />
**NOTE: Once the change of status request has been filed, you MUST NOT leave the country. If you leave the<br />
country before the request is decided by USCIS, you forfeit the application. If the request for a change of status is<br />
approved, you may stay in the USA for as long as you are maintaining the guidelines of your status. HOWEVER,<br />
IF YOU LEAVE THE USA AT ANY TIME (EVEN AFTER USCIS APPROVES YOUR CHANGE TO F-1 STATUS),<br />
YOU WILL HAVE TO VISIT A U.S. EMBASSY OR CONSULATE OFFICE IN OR NEAR YOUR HOME COUNTRY<br />
TO RE-ENTER THE USA WITH AN F-1 VISA. CHANGING STATUS IN THE U.S. DOES NOT MEAN YOU<br />
HAVE AN F-1 VISA. CHANGING STATUS IN THE USA DOES NOT GUARANTEE THAT YOU WILL BE GIVEN<br />
AN F-1 VISA AT THE EMBASSY TO RE-ENTER THE USA.<br />
***** It is recommended not to change address while application is pending *****<br />
***NOTE: Individuals who entered the United States on a B1/B2 or F-2 visa are not a<strong>ll</strong>owed to begin studies until<br />
receiving approval on a request for a change of status to F-1. J1 or H visa holder however, may enro<strong>ll</strong> for a fu<strong>ll</strong><br />
course of study while approval is pending. The application process could possibly take several months.<br />
I have read this page and understand the requirements for changing status. I know that a copy of this page is<br />
provided to me upon request.<br />
___________________________________________<br />
NAME OF STUDENT/APPLICANT (Please print)<br />
____________________________________________<br />
Signature/Date<br />
Disclaimer notice – <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege is providing this application packet and information to non-immigrants who wish to<br />
change their current non-immigration status to F1 (student status) while in the United States. We are not lawyers; therefore this information is<br />
not legal advice. Always consult a competent immigration lawyer before taking any legal action that may affect your immigration status.<br />
Please note that immigration laws and regulations change frequently. We cannot guarantee that this information is always up-to-date and<br />
correct. It is your responsibility not the co<strong>ll</strong>ege to maintain “ In Status” with your current non-immigrant status while in the United States.
ADDITIONAL INFORMATION FOR SPECIAL VISA STATUSES<br />
Special instructions:<br />
A visa status (A-1, A-2 or A-3): Before you submit an application for change of status to USCIS, you must complete Form I-<br />
566 and send it to the Department of State for a recommendation. The recommendation must be enclosed with your change<br />
of status application packet when it is sent to USCIS. If the department does not recommend approval, USCIS wi<strong>ll</strong> also not<br />
approve your change of status.<br />
You must submit form I-566 to:<br />
Office of the Protocol<br />
Department of State<br />
Washington, D.C. 20520<br />
F2: If an F-2 spouse or child wishes to begin an academic program, he/she must change to F-1 status prior to enro<strong>ll</strong>ment.<br />
The F-2 should show that he/she is going to attend school fu<strong>ll</strong>-time. The original F-1 spouse should also submit proof that<br />
he/she continues to be in status at the time of the application. A<strong>ll</strong> applications for F-1 from F-2 must submit proof of the<br />
relationship to the F-1 (e.g. birth or marriage certificate). F-2 dependents must include a copy of his/her SEVIS I-20 form.<br />
G ( G-1, G-2, G-3, G-4 or G-5): Before applying for a change of status to F-1, you must complete Form I-566 and submit to<br />
the Department of State for a recommendation. Complete Form I-566 and send it to the Department of State for a<br />
recommendation. The recommendation must be enclosed with your change of status application packet when it is sent to<br />
USCIS. If the department does not recommend approval, USCIS wi<strong>ll</strong> also not approve your change of status. Form I-566<br />
must be signed by an official of the diplomatic mission employing you or your parent or spouse. You may not change from any<br />
G status as long as you or your principal spouse or parent is accredited as a diplomat. If the employer is the United Nations or<br />
a mission to the UN, Form I-566 is submitted to the United States Mission to the UN, 799 UN Plaza, New York, NY 10017.<br />
Otherwise, the application should go to the Office of the Protocol, US Department of State, Washington, D.C. 20520.<br />
NOT ELIGIBLE FOR CHANGE OF STATUS<br />
C1, C2, C3<br />
D1 OR D2<br />
J1 with Two-year home residency requirement<br />
K1, or K2<br />
M1 or M2<br />
S1 or S2<br />
WB or WT
SEVIS FEE PAYMENT INFORMATION ( FORM I-901)<br />
Payment By Credit Card<br />
Go to www.fmjfee.com and fo<strong>ll</strong>ow on-line instructions. Print out the receipt or payment screen and include in your application<br />
packet for change of status. SEVIS Fee is $200 US do<strong>ll</strong>ars.<br />
Payment By Mail<br />
Go to www.fmjfee.com to download Form I-901 and fi<strong>ll</strong> it out. Mail the completed form with a check or money order of $200.<br />
Once the information and fee are processed, SEVIS would then be updated with the fee payment information and wi<strong>ll</strong> send<br />
you the receipt in the mail. Include the payment receipt in your application packet for change of status.<br />
Mail your payment and Form I-901 to:<br />
I-901 Student/Exchange visitor Processing Fee<br />
P.O. Box 970020<br />
St. Louis, MO 63101<br />
A<strong>ll</strong> checks and money orders must be:<br />
Payable to the I-901 Student/Exchange visitor Processing Fee<br />
Only checks and money orders may be used when paying by mail.<br />
The check or money order must be made in U.S. do<strong>ll</strong>ars and drawn on a bank located in the United States.
Maintenance of Student F-1 Status Agreement Form<br />
Student Name____________________________________ Student ID NO____________________<br />
Program of Study__________________________________ I-20 St/End Dt________________<br />
To maintain F- I status, students must:<br />
1. Maintain a valid Passport. Your passport must be valid for at least 6 months into the future.<br />
2. Attend the school (AACC) you are authorized to attend (you should be attending the school that<br />
the United States Citizenship and Immigration Services (USCIS) last authorized for attendance-see<br />
the DHS stamp in the upper right corner of the I-20ID--or the school that has processed a<br />
transfer with the USCIS).<br />
3. Apply for extensions of program before the expiration date on the I-20. Must apply 30 days<br />
before the program end date on the I-20 form.<br />
4. Fo<strong>ll</strong>ow proper procedures for changing from one program or educational level to another (e.g.,<br />
from English as a Second Language degree to Associate’s degree or Bachelor’s degree).<br />
5. Fo<strong>ll</strong>ow proper procedures for transferring from one school to another.<br />
6. Limit on-campus employment to 20 hours a week while school is in session (fu<strong>ll</strong>-time oncampus<br />
employment is permitted during vacation periods such as summer, as long as student<br />
was enro<strong>ll</strong>ed fu<strong>ll</strong>-time the term previous and intends to be fu<strong>ll</strong>-time the fo<strong>ll</strong>owing term).<br />
7. Refrain from off-campus employment without authorization. Limit off-campus employment (with<br />
authorization through economic hardship or part-time practical training) to 20 hours per week<br />
while school is in session.<br />
8. Take no more than one online course per semester.<br />
9. Report a change of address to USCIS and DSO within 10 days of the change.<br />
10. Pursue a fu<strong>ll</strong> course of study and make normal progress towards the completion of the course<br />
of study: Fu<strong>ll</strong>-course of study and fu<strong>ll</strong>-time study are defined in the regulations as fo<strong>ll</strong>ows:<br />
o undergraduate students: at least 12 credit hours per term, or the equivalent (as<br />
determined by district director in the school approval process)*<br />
o student in postsecondary language liberal arts, fine arts, or other nonvocational program<br />
which confers associate or other degrees: at least 12 clock hours of instruction a week or<br />
its equivalent (as determined by the district director in the school approval process)*<br />
I have reviewed the regulations governing maintenance of visa status and have read page 2 of my I-20<br />
form. I accept and wi<strong>ll</strong> abide by the USCIS regulations and a<strong>ll</strong> <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege<br />
policies concerning the federal and state F-1 student compliance guidelines.<br />
I also certify that I know and understand the information on the Maintenance of Status Form and that I<br />
understand that it is my responsibility to notify not only the Records and Registration Office but also the<br />
Admissions Office of any change in information contained in my initial application and current records. I<br />
also understand that the information given to the Admissions Office is both accurate and complete and<br />
that I am aware of the imposed USCIS consequences for being of compliance with my F-1 status.<br />
Student’s signature __________________________________________ Date _________<br />
Co<strong>ll</strong>ege Official ____________________________________________ Date _______
Admissions and Enro<strong>ll</strong>ment Development, SSVC 100<br />
101 Co<strong>ll</strong>ege Parkway<br />
Arnold, MD 21012 Telephone number: 410-777-2677 Fax number: 410-777-4022<br />
Applicant, please answer a<strong>ll</strong> applicable questions. Make sure you have a<strong>ll</strong> the required documents to<br />
be attached to this form when submitting to the co<strong>ll</strong>ege.<br />
PERSONAL INFORMATION<br />
Gender: Male Female<br />
Name___________________________________________________________________________<br />
Last First Middle or Maiden Name<br />
Current U.S. Address:___________________________________________________________________<br />
Street Number<br />
________________________________________________________________________________<br />
City State Zip Code County<br />
How long have you lived at your current address?<br />
Less than 3 months Three to Six months Six months or more<br />
Telephone _____________________________ _______________________ _______________________<br />
Home Business/Work Ce<strong>ll</strong>ular/Mobile<br />
Home Country Telephone _____________________________________________________________<br />
U.S. Social Security Number (if any)______________-______________-________________<br />
Date of Birth___________________ Place of Birth_________________Country of Citizenship___________<br />
Month/Day/Year<br />
City of Birth__________________________________Country of Birth _______________________________<br />
Native Language_______________________________Secondary Language___________________________<br />
Email: _____________________________________________________________________________________<br />
FOREIGN ADDRESS<br />
Please enter your permanent address in your country.<br />
F-1<br />
INTERNATIONAL<br />
STUDENT ADMISSION<br />
APPLICATION<br />
______________________________________________________________________________________<br />
Street Address/Number<br />
_______________________________________________________________________________<br />
City or Province Country ZIP code
VISA INFORMATION<br />
Applicants who are currently living in the United States must provide visa information.<br />
If you are currently living in the United States, a copy of both sides of Form I-94, “Arrival and Departure” Record<br />
(a sma<strong>ll</strong> white card inside your passport), a copy of your passport’s front page, the US Visa Form I-20 for F-1<br />
transfers and DS-2019 for J1 visa holders must be attached to this form.<br />
1. Are you currently holding a valid Form I-20 issued by another institution and wish to transfer to AACC? YES NO<br />
If YES, Name of the institution_____________________________ I-20 Program End Date______________________<br />
2. Are you currently in the United States and applying to change your current non-immigrant status to F-1? YES NO<br />
What is your current visa status F1 F2 B1 B2 J1 None Other:_______________________<br />
I-94 Entry Date_________ I-94 Departure Date_______Admission number (11 digit number on your I-94 card) __________<br />
Visa Type_________________Visa Number _______________________Visa Issuing Post_______________________<br />
Visa Issue Date:__________ Visa Expiration Date__________________ Visa Issuing Country____________________<br />
Passport Number___________ Passport Expiration Date___________ ___ Passport Issuing Country_______________<br />
Port of Entry_ _____________________________________Country Entry Date_______________________________<br />
ETHNIC BACKGROUND<br />
Black/African American Asian or Pacific Islander Hispanic<br />
Native American or Alaskan Native Caucasian Non-Hispanic<br />
Other____________________________<br />
EMERGENCY CONTACT INFORMATION<br />
______________________________________________________________________________________<br />
Last Name First Name Middle/Maiden Name<br />
___________________________________________ ___________________________________<br />
Relationship to you (e.g. spouse, relative, friend) Telephone<br />
HIGH SCHOOL INFORMATION<br />
Most recent high school attended.<br />
_____________________________________ _________________________________<br />
Name of High School Date Graduated (Month/Day/Year)<br />
COLLEGE INFORMATION<br />
Please list a<strong>ll</strong> institutions previously attended starting with the most recent one.<br />
Name of Co<strong>ll</strong>ege/University City and State or Country Degree Earned Dates Attended<br />
______________________________ ___ _______________ __________________ ________________<br />
______________________________ ___________________ _________________ ________________<br />
______________________________ ___________________ _________________ ________________<br />
Have you taken the TOEFL test or AACC Placement test? YES NO
TEST____________________________Score/Level _________________________________________<br />
When wi<strong>ll</strong> you attend AACC: Year_______ Fa<strong>ll</strong> (Aug.-Dec.) Spring (Jan.-May) Summer (May-Aug.)<br />
( Circle one )<br />
ACADEMIC PROGRAM OF STUDY/EDUCATIONAL GOAL<br />
1. My goal is to earn an associate of arts (AA), associate of<br />
science (AS) or associate of arts in teaching (AAT) degree so that<br />
I can transfer to a four-year co<strong>ll</strong>ege or university. My program is:<br />
(please check only one).<br />
TRANSFER PREP DEGREE PROGRAMS MINIMUN 60 CREDITS REQUIRED<br />
� American Studies Option………………………….AA.AMS.AMS<br />
� Business Administration Transfer. ……………….AS.BPA.ADM<br />
Computers<br />
� Computer Information Systems Option…………………AS.CPS.CIS<br />
� Computer Science Transfer…………………….….……AS.CPS.SCI<br />
� Management Information Systems Option……….…….AS.CPS.MIS<br />
Education<br />
� Teaching (Early Childhood A.A.T.)……...AAT.EDU.EARLYCHILD<br />
� Teaching (Elementary A.A.T.)……………………..AAT.EDU.ELEM<br />
� Teaching Chemistry (Secondary A.A.T.) ..…..AAT.EDU.SEC-CHEM<br />
� Teaching Mathematics (Secondary A.A.T.)… AAT.EDU.SEC-MATH<br />
� Teaching Physics (Secondary A.A.T.)……. ….AAT.EDU.SEC-PHSY<br />
� Teaching Spanish (Secondary A.A.T.)…… …… AAT.EDU.SEC-SPA<br />
� Engineering Transfer…………………………………AS.EGR.EGR<br />
Fine Arts Options<br />
� Art History/Museum Education Option……………..AA.FA.AH-ME<br />
� Dance Option……………………………………….AA.FA.DANCE<br />
� Film Studies Option…………………………………...AA.FA.FILM<br />
� Graphic Design ……………………..…AA.FA.GRAPHIC-DESIGN<br />
� Music Option……………………………..…………..AA.FA.MUSIC<br />
� Theater Arts Option……………………………….AA.FA.THEATER<br />
� Visual Arts Option………………………….………AA.FA.VISUAL<br />
General Studies Transfer………………………………….……AA.GEN.STDS<br />
Law<br />
� Law and Jurisprudence………………….AA.LGS.JURIS-TRANS<br />
Liberal Arts Option…………………………………………AA.LIBERAL.ARTS<br />
Mathematics…………………………………………………..AS.MATH.MATH<br />
Medical<br />
� Gerontology…………………………AS.HUS.GERONTOLOGY<br />
� Medical Technology Option………………AS.SPM.MED-TECH<br />
� Nursing Option…………………………………AS.NUR.TRANS<br />
� Pre-Dental Hygiene Option……………………AS.SPM.PD-HYG<br />
� Pre-Medical/Pre-Dental Option………………..…AS.SPM.PM-PD<br />
� Pre-Optometry Option…………………………AS.SPM.PRE-OPT<br />
� Pre-Pharmacy Option………………….…….AS.SPM.PRE-PHAR<br />
� Pre-Physical Therapy Option……………………AS.SPM.PRE-PT<br />
� Pre-Veterinary Option…………………….…AS.SPM.PRE-VET<br />
Science<br />
� Astronomy Option………………………………………AS.SPM.AST<br />
� Biology Option…………………………..……………..AS.SPM.BIOL<br />
� Chemistry Option……………………………………AS.SPM.CHEM<br />
� Environmental Science Option……………………….AS.SPM.ENVI<br />
� Physics Option……………………………………… AS.SPM.PHYS<br />
� Plant Science – Botany Option………………………..S.SPM.PS-BOT<br />
� Plant Science – Horticulture Option………………AS.SPM.PS-HORT<br />
Undeclared………………………………..………………AA.GEN.UND-TRAN<br />
2. My goal is to earn an associate of applied science (AAS) so<br />
that I can prepare for a career or possible transfer* to a fouryear<br />
co<strong>ll</strong>ege or university. My program is:<br />
Interior Design<br />
� Architecture Option……………………………..…AAS.ACH.ARCH<br />
� Construction Management Option…………AAS.ACH.CSTN-MGMT<br />
� Interior Design Option…………………………AAS.ACH.INT-DSGN<br />
Business<br />
� Business Enterprise Systems….……………..AAS.BES.ENTPRS-SYS<br />
� Business<br />
Management……………………………………….AAS.BMT.MGMT<br />
� Financial Accounting……………………..……AAS.BPA.FIN-ACCT<br />
� Fire Management…………………..……….AAS.BPA.FIRE-MGMT<br />
Communication Arts<br />
� Interactive Technologies Option…………… AAS.CAT.INTR-TECH<br />
� Media Production Option………………..……….AAS.CAT.MEDIA<br />
Computers<br />
� Computer Network Management……………………AAS.CIS.CNM<br />
� General Technology……………………………AAS.CIS.GEN-TECH<br />
� Information Systems Security………………….………AAS.CIS.ISS<br />
� Personal Computer Systems Technology Option…AAS.CIS.PC-SYS<br />
� Programming/Analysis Option………………………AAS.CIS.PROG<br />
� Web Technologies……………………….AAS.CPS.WEB-TECH<br />
Education<br />
� Early Childhood Development……………………AAS.EDU.ECD<br />
Electronic Engineering Technology<br />
� Electronics Option………………………………AAS.EGR.ELEC<br />
� Telecommunications Option………..……………AAS.EGR.TELE<br />
Hotel/Restaurant Management<br />
� Culinary Arts Operations Option…………..AAS.HRM.CULINARY<br />
� Hospitality Business Management………….AAS.HRM.HSP-BMGT<br />
Human Services<br />
� Addiction Counseling………………………AAS.HUS.ADDICTION<br />
� Human Services……………………………………..AAS.HUS.HUS<br />
� Law and Social Practice………………………AAS.HUS.LAW-SOC<br />
Law<br />
� Cybercrime…………………….…………AAS.LEN.CYBR-CRME<br />
� Forensic Studies………….……………….…AAS.LEN.FORNSC.SCI<br />
� Homeland Security Manage..…………AAS.HLS.HMLD.SEC-MGT<br />
� Juvenile Justice……………………………..……AAS.CJS.JUV-JUST<br />
� Law Enforcement and Criminal Justice……..……….AAS.LEN.LEN<br />
� Police Academy Option……………..………AAS.LEN.POL-ACAD<br />
� Social Justice Option………………..………….AAS.LEN.SOC-JUS<br />
Medical (selective admission)**<br />
� EMT-Paramedic……………………..……………AA.GEN.EMT-P<br />
� Histotechnology Option†……..……………….AA.GEN.HISTOTECH<br />
� LPN to RN Upward Mobility Option………..…………AA.GEN.RN<br />
� Nursing (RN)…………………………………..……….AA.GEN.RN<br />
� Physical Therapist Assistant……………………….……AA.GEN.PTA<br />
� Radiologic Technology……….………………………AA.GEN.RAD<br />
� Therapeutic Massage………………….…………AAS.IHE.TH-MASS<br />
Medical (open admission)<br />
� Medical Assisting………………………………AAS.MDA.MDA<br />
Paralegal Studies<br />
� Business Option….……………………………AAS.PARA.BUSN<br />
� General Practice Option…………….……….AAS.PARA.GENL<br />
� Litigation Option……………….…………AAS.PARA.LITG<br />
Undeclared…………………………………………………AA.GEN.UND-CAR<br />
3. My goal is to earn a certificate, which requires fewer hours<br />
than an associate of applied science degree, so that I can
update my job ski<strong>ll</strong>s. My program is:<br />
Architecture and Interior Design<br />
� Architectural CAD Option………………..……..……CRT.ACH.CAD<br />
� Architectural I<strong>ll</strong>ustration Option………….…...……..CRT.ACH.ILLN<br />
� Construction Management Option……….…CRT.ACH.CSTN-MGMT<br />
� Interior Design Option…………………………CRT.ACH.INT-DSGN<br />
Business<br />
� Advertising/Marketing Option…………..……CRT.BMT.ADV-MKT<br />
� Business Communications Option……. ………..CRT-BMT.COMM<br />
� Business Office Management Option………CRT.BMT.OFF-MGMT<br />
� Computer Information Systems Option………...……CRT.BMT.CIS<br />
� Economics/Finance Option……………………CRT.BMT.ECO-FIN<br />
� Video Production Option………..…………………CRT.CAT.VIDEO<br />
Computers<br />
C Language Option………………………………………CRT.CIS.CLANG<br />
� Computer Network Management………………………CRT.CIS.CNM<br />
� Electronic Office Option….……………………CRT.CIS.ELEC-OFF<br />
� General Technology……………………………CRT.CIS.GEN-TECH<br />
� Help Desk Specialist Option………………...CRT.CIS.HELP-DESK<br />
� Information Systems Security…………………………CRT.CIS.ISS<br />
� Personal Computer Technician .Option……...……CRT.CIS.PC-TECH<br />
� Scientific Programming Option…………………CRT.CIS.SCI-PROG<br />
� Systems Option……………………………..……CRT.CIS.SYSTEMS<br />
� UNIX/LINUX System Administrator Option…….CRT.CIS.UNIX-SA<br />
� Visual Basic Option……………………………..……....CRT.CIS.VB<br />
� World Wide Web Programming and Design…CRT.CIS.WWW-PROG<br />
Designing and Drafting Technology (Computer-aided)…….. …CRT.EGR.CAD<br />
Education<br />
� Child Care………………………. .………..CRT.EDU.CHILD-CAR<br />
Special Education Support<br />
� Emotional Disturbance Option……………CRT.EDU.SES.EMOTION<br />
� Autism Spectrum Disorders Option ….……CRT.EDU.SES.AUTISM<br />
� Speech and Language Option ………..………CRT.EDU.SES.SP-LG<br />
� Preschool/Early Childhood Option ………….RT.EDU.SES.PRES-EC<br />
� Mental Retardation Option …………..……CRT.EDU.SES.MENTAL<br />
� Learning Disabled Option…. ……………….,…….CRT.EDU.SES.LD<br />
� Behavioral Support Services Option …..….CRT.EDU.SES.BEH-SUP<br />
� Teaching Paraprofessional ………….CRT.EDU.PARA-TEACH<br />
Electronic Engineering Technology<br />
� Electromechanical Option…………….CRT.EGR.ELEC-MECH<br />
� Electronics……………………………….…….CRT.EGR.ELEC<br />
� PC Repair Option……………….………CRT.EGR.PC-REPAIR<br />
� Telecommunications Option………..…………CRT.EGR.TELE<br />
� Financial Accounting…………………CRT.BPA.FIN-ACCT<br />
� Gerontology……………..………CRT.HUS.GERONTOLOGY<br />
Hotel/Restaurant Management<br />
� Baking and Pastry…………………………CRT.HRM.BAK-PASTRY<br />
� Culinary Arts Operations Option….…………CRT.HRM.CULINARY<br />
� Food Service Operations<br />
ManagementOption…………………………CRT.HRM.FOOD-SERV<br />
� Hotel Restaurant Management: Catering<br />
Operations……………………………………CRT.HRM.CATERING<br />
Human Services<br />
� Electronic Commerce Option……………………CRT.BMT.E-COM<br />
� EMS/Fire/Rescue Management Option……CRT.BMT.EMS-MGMT<br />
� Financial Accounting Option………………..CRT.BMT.FIN-ACCT<br />
� Health Care Professionals Option…….CRT.BMT.HEA-CARE-PRF<br />
� Hotel Front Desk Management Option..CRT.BMT.FRTDESK.MGMT<br />
� Hotel/Restaurant Management Option…..…CRT.BMT.HRM-MGMT<br />
� Human Resources Option………………..…CRT.BMT.HUM-MGMT<br />
� Sma<strong>ll</strong> Business Option…………………..……CRT.BMT.SML-BUS<br />
� Total Quality Management (TQM) Option……..…CRT.BMT.TQM<br />
Communication Arts Technology<br />
� Graphic Design Option………………………CRT.CAT.GR-DSGN<br />
� Photography Option…..…………………………CRT.CAT.PHOTO<br />
Law<br />
CERTIFICATION<br />
� Human Services…………………….…………………CRT.HUS.HUS<br />
� Human Services Direct Support…………..………CRT.HUS.DIRSUP<br />
� Cybercrime………………………………….CRT.LEN.CYBR-CRME<br />
� Juvenile Services Institutional Support Staff.….CRT.CJS.JJ-INSTSUP<br />
� Juvenile Services Resident Adviser……….……CRT.CJS.JJ-RESADV<br />
� Law Enforcement and Criminal Justice………………CRT.LEN.LEN<br />
� Police Academy Option……………..………CRT.LEN.POL-ACAD<br />
Medical (selective admission)*<br />
� EMT Intermediate ………..……………….AA.GEN.EMT-INTER<br />
� EMT-Paramedic…..……………………………AA.GEN.EMT-CRT<br />
� Physician Assistant……………………….…………...AA.GEN.PA<br />
Medical (open admission)<br />
� Managed Care Operations…………………CRT.IHE.MGMT-CARE<br />
� Medical Assisting…………………………………..CRT.MDA.MDA<br />
� Medical Coding………………………………CRT.IHE.MED-CODE<br />
� Patient Care<br />
Technician……………………………………………CRT.NUR.PCT<br />
� Pharmacy Technician………………………..CRT.IHE.PHAR-TECH<br />
� Therapeutic Massage……………………………CRT.IHE.TH-MASS<br />
Paralegal Studies (requires minimum of Associate’s degree)**<br />
� Business Option……………………………………CRT.PARA.BUSN<br />
� General Practice Option…………………….…….CRT.PARA.GENL<br />
� Litigation Option………………………….………..CRT.PARA.LITG<br />
� Nursing Paralegal Option (requires Nursing<br />
degree)…………………………………………….CRT.PARA.NURS<br />
Publication/Design on the Internet<br />
� Graphic Design Option……………………………….CRT.CAT.PDI<br />
� Programming Option………………………………….CRT.CPS.PDI<br />
Retail Management ………………………..………CRT.BPA.RETAIL-MGMT<br />
� Science Laboratory Management………….CRT.SCI.LAB-MGMT<br />
� Women’s Studies …………. ………….…………CRT.WMS.STDS<br />
� Undeclared…………………………….………AA.GEN.UND-CRT<br />
4. My goal Is to take English as a Second Language(ESL)<br />
courses In order to Improve my language ski<strong>ll</strong>s before<br />
taking credit courses.<br />
English as a Second Language ………CRT.ESL.ESL<br />
In completing and submitting this application, I agree to accept and abide by the policies and regulations of <strong>Anne</strong> <strong>Arundel</strong><br />
<strong>Community</strong> Co<strong>ll</strong>ege concerning drug and alcohol abuse and understand that the unlawful use of drugs or alcohol wi<strong>ll</strong> subject<br />
me to the penalties contained in those policies and regulations. I understand that it is my responsibility to maintain “in status”<br />
with my current visa status. I also certify that the information I have given on this form is true, accurate and complete.<br />
Student’s Signature _____________________________ Date _________________________________<br />
An equal opportunity, affirmative action, Title IX, ADA Title 504 compliant institution. Ca<strong>ll</strong> Disability Support Services, 410-777-2306 or Maryland Relay<br />
711, 72 hours in advance or e-mail dss@aacc.edu to request special accommodations. For information regarding <strong>Anne</strong> <strong>Arundel</strong> <strong>Community</strong> Co<strong>ll</strong>ege's<br />
compliance and complaints concerning discrimination or harassment, ca<strong>ll</strong> Karen L. Cook, Esq., AACC’s federal compliance manager, at 410-777-7370 or<br />
Maryland Relay 711.