Educational Experience Summary (Application For Admission) (Page 2 of 2) in pdf

Admission Information

Wayne County Community College District

(PLEASE PRINT OR TYPE)

– ANSWER ALL ITEMS –

International Student

Application for Admission

WELCOME

The Admission Office must receive the required information before the

Wayne County Community College District (WCCCD) welcomes

beginning of the term of intended enrollment. Applicants who do not

applications from international students who have completed

complete the College admission requirements in time for their expected

secondary education and are eligible for admission to college-level stud-

term of enrollment will be required to wait for the next term for admis-

ies. An accredited two-year community college, WCCCD offers the fol-

sion consideration.

lowing degrees: Associate of Arts, Associate of Science, Associate of

Mr.

Ms. Name: (Given) ____________________________(Middle) ______________________(Family) ________________________________Gender ______________

Applied Science, Associate of General Studies and

GENERAL INFORMATION

PRESENT ADDRESS

certificates in a variety of programs.

Wayne County Community College District has no financial aid or

scholarships for international students. In addition, it is a commuter

Number and Street________________________________________________________Town/City ________________________Province/State ______________________Country ______________Zip Code ____________

ABOUT WAYNE COUNTY COMMUNITY COLLEGE

college and has no dormitory facilities. It is the student’s responsibility

The College serves as a leader providing educational services and train-

to locate and finance living accommodations.

Permanent Address (Overseas)

ing to residents of Southeast Michigan. Distinctive in its purpose and

Number and Street________________________________________________________Town/City ________________________Province/State ______________________Country ______________Zip Code ____________

history, WCCCD was established by a public mandate and chartered in

STATEMENT OF COMPLIANCE WITH

1967. In 1969, the first classes were offered by the institution known as

FEDERAL AND STATE LAW

Telephone Number __________________________________________________________ Email Address ________________________________________________________________

the “college without walls,” reflecting that WCCCD had no buildings

Wayne County Community College District, pursuant to the require-

or facilities of its own. By 1982, the College had constructed five cam-

ments of Titles VI and VII of the Civil Rights Act of 1964; Title IX of

Country of Birth ____________________________________________________________ Date of Birth (month/day/year)__________________________________________________

puses within its 550-square-mile service district. As a two-year “open

the Education Amendments of 1972; Section 504 of the Rehabilitation

door” institution, WCCCD is committed to providing an affordable

Act of 1973; the Age Discrimination Act of 1975; The Vietnam-Era

Country of Citizenship ______________________________________________________ Country of Nationality _________________________________________________________

high-quality education in an atmosphere of friendly support and

Veterans Readjustment Act of 1974; the Elliott-Larsen Civil Rights Act,

If currently in U.S., State VISA Status ____________Expiration Date of VISA ____________________________

encouragement.

and Executive Order 11246, complies with all Federal and State laws

and regulations prohibiting discrimination and with all requirements

EMERGENCY CONTACT (in the United States)

LOCATION

and regulations of the U.S. Department of Education. It is the policy of

Wayne County Community College District’s five facilities are located

WCCCD that no person, on the basis of race, color, religion, national

Mr.

Ms. Name: (Given) ________________________________(Middle) ______________________(Family) ______________________

in suburban, urban, and rural areas of Wayne County. Metropolitan

origin, age, sex, height, weight, marital status or handicap, shall be dis-

Detroit offers a broad choice of cultural institutions and recreational

criminated against, excluded from participation in, denied the benefits

Number and Street________________________________________________________Town/City ________________________Province/State ______________________Country ______________Zip Code ____________

activities, including major sports teams. In addition to being the world’s

program, or activity for which it is responsible or for which it receives

automotive capital, Detroit is host to leading medical institutions, high-

financial assistance from the U.S. Department of Education.

Telephone Number____________________________________________________________________

technology manufacturers, and international-class financial institutions.

(Policy adopted by the Wayne County Community College District Board of

Relationship:

Parent

Legal Guardian

Spouse

Uncle/Aunt

Other

Trustees July 28, 1993)

INTERNATIONAL STUDENT ADMISSION POLICY

Intended field of study________________________________________________________________________________________________________________________________

_____________

The international applicant who wishes to study at Wayne County

NOTICE OF NONDISCRIMINATION POLICY

Community College District shall have completed his or her secondary

Any questions concerning Title IX of the Education Amendments of

Educational objective:

Transfer to a senior college

Associate’s degree only – not transferring to senior college

Associate’s degree and transfer to a senior college

education and be eligible for admission to college-level studies.

1972, which prohibits discrimination on the basis of sex, or inquiries

I.D. Number ___ ___ ___-___ ___-___ ___ ___ ___

International applicants should begin the admission process at the earli-

related to Section 504 of the Rehabilitation Act of 1973 which pro-

est possible date. Three to six months is recommended to ensure enroll-

hibits discrimination on the basis of handicap, and inquiries related to

Check semester you wish to begin at WCCCD:

Fall

Spring

Summer

Year ____________

ment as requested. Wayne County Community College District

Title II of the Americans with Disabilities Act (ADA), which provides

requires the following for admission:

comprehensive civil rights protection for individuals with disabilities, or

Did you take the TOEFL TEST?

Yes

Date taken ____________Score ____________________ (Official scores must be sent to the Admissions Office)

the College’s Statement of Compliance with Federal and State law,

Did you take the Michigan test?

Yes

Date taken ____________Score ____________________ (Official scores must be sent to the Admissions Office)

1. Completed Wayne County Community College District

should be directed to Director of Human Resources, Wayne County

International Student Application (with original signatures, no

Community College District, 801 W. Fort, Detroit, MI 48226 or by

SECONDARY SCHOOL FROM WHICH YOU GRADUATED OR WILL GRADUATE

copies) for Admission form submitted by the application deadline.

calling: 313-496-2887.

Please provide complete information. Incomplete forms will result in

Dates Attended

delays in reviewing applications

ACCREDITATION

Name of Institution

Location

From

Name of Diploma/Certificate

Date Received

2. Official high or secondary school transcript/certificate showing com-

Wayne County Community College District is accredited by the North

pletion, with English translation.

Central Association of Colleges and Schools (30 North LaSalle Street,

3. Official university/college transcripts (If applicable)

Suite 2400, Chicago, Illinois 60602-2504, phone:

4. English Language Proficiency Scores. (TOEFL or MICHIGAN

1-800-621-7440). In addition, specific program accreditation has been

TEST ONLY). All applicants, except those from countries where

granted by the following accrediting bodies:

Mark Average Received __________________________ Class Rank __________________________

English is the only official language, are required to furnish satisfac-

• American Dental Association Commission on Dental Accreditation

tory evidence that the applicant's competency in English is adequate.

• American Dietetic Association

UNIVERSITY OR INSTITUTIONS OF HIGHER LEARNING ATTENDED

Minimum TOEFL scores are: a)Paper Based Test – 500; b) Internet

• Michigan Corrections

Dates Attended

Based Test -69; c) Michigan Test Score of 70 or above.

• Accreditation Council for Occupational Therapy Education

5. Complete a valid Affidavit of Support, Form I-134 signed and

Several programs are approved by the following governing bodies:

Name of Institution

Location

From

Name of Diploma/Certificate

Date Received

notarized with a bank seal Statement of Financial Support verifying

• American Veterinary Medical Association

financial status of the sponsor for a minimum of US$17,209.

• Federal Aviation Administration

Transfer Students

1. If you are currently an F-1 student in the U.S. and want to transfer

to Wayne County Community College District, you must submit

the following documents.

2. Complete steps 1-5 listed above under New Students (above) and

SPONSOR’S NAME/ADDRESS

the steps listed below:

• An International Student Transfer Clearance Form completed by

Mr.

Ms. Name: (Given) ________________________________(Middle) ______________________(Family) ______________________

the International Student Advisor at your current school.

• A photocopy of your I-20, I-94 card, and a copy of the visa page

Number and Street________________________________________________________Town/City ________________________Province/State ______________________Country ______________Zip Code ____________

of your passport.

2/2010_0490 rev 8/2010

Return completed form to: International Student Center, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226