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Eastern Oregon University is committed to providing equal education opportunities to all qualified students without regard to race, color, sex, national origin, age religion, marital status, disability, veteran status, sexual orientation, gender identity or gender expression. Direct related inquiries to the Affirmative Action Office, Human Resources, One University Blvd., La Grande, OR 97850; phone 541-962-3548.

One University Blvd.La Grande, OR 97850541-962-3393 or 800-452-8639FAX: 541-663-9825international@eou.eduwww.eou.edu/international

Application for International AdmissionApplication deadlines: Fall term: September 1 Winter term: December 1 Spring term: March 1 Summer term: June 1

For additional information about becoming admitted to Eastern Oregon University, go to eou.edu/admissions/international-requirements. Admission is for degree seeking students. If you were previously admitted and have not earned a degree, use the Returning Student Application at eou.edu/admissions/apply. For international admissions procedures go to eou.edu/international and select Info sheet/Checklist. A $90 application fee (non-refundable) is required.

Year and term you plan to begin: Year _____ Summer _____

New/freshman _____

Fall _____ Winter _____ Spring _____

Transfer _____ Post-baccalaureate _____Student type:

Primary location: La Grande campus _____ Regional center (COFA only) _____ Online _____

__ __ __ __ __ __ __ __ __ (For internal use only)

Personal informationSocial Security Number (if applicable)*See enclosed disclosure and consent statement.

Legal name exactly as it appears on your passport.

Legal name ___________________________________________________________________________________________________ Last /surname (Required) First/given Middle

Other name(s) that may appear on your academic records:

_____________________________________________________________________________________________________________ Last/surname First/given Middle

_____________________________________________________________________________________________________________ Current mailing address (Required) City Province/State Country Zip

_____________________________________________________________________________________________________________ Permanent address (Required) City Province/State Country Zip

_____________________________________________________________________________________________________________ Home phone (Required) E-mail address

___________________________________________________________ r Check here to receive crucial information from EOU by text. Cell phone

r Check here to receive EOU Emergency Alert System texts.

Emergency contact information: Please provide parent(s), legal guardian, relative or friend that can be reached in case of emergency. r Parent(s) r Legal guardian r Other (specify) _________________________

_____________________________________________________________________________________________________________ Last First Middle

_____________________________________________________________________________________________________________ Mailing address City Province/State Country Zip

_____________________________________________________________________________________________________________ Primary phone Cell ___ home ___ E-mail address

Your gender** Male ___ Female ___ Your date of birth ______ / ______ / ______ Month/Day/Year

Ethnic/racial identification: Please indicate your ethnic identity by selecting one of the following: (Note: In compliance with federal reporting requirements, EOU must seek to identify the ethnic background of applicants for admission. You are encouraged to supply this information, but may decline without prejudicing your application in any way.

r Hispanic r Non-Hispanicr White, European American r Asian American (specify ethnic group) __________________________ r Pacific Islander (specify ethnic group) __________________________ r Hispanic American (specify ethnic group) _______________________ r American Indian (specify tribal affiliation) ____________________________________________________________

r Alaska Nativer Black, African Americanr Middle Eastern (specify ethnic group) __________________________r North African (specify ethnic group) __________________________r If none of the above is appropriate for you, please write in the ethnic/racial identification you use ____________________________________

Academic informationWhat is your degree objective: Bachelor _____ Associate _____ Certificate _____

Primary major: __________________________________________________________________ Undecided _____

What is your career objective: ______________________________________________________ Undecided _____

Secondary/high school information: Please complete even if you will be entering as a transfer or graduate.

_____________________________________________________________________________________________________________Name secof ondary/high school City/Country

Date of graduation or date you expect to graduate from secondary/high school: ________________

Colleges/universities attended: List below every college and/or university you have attended or are currently attending whether or not credits were earned. Omitting a prior college or university from this list may result in denial of admission or disciplinary action. Send official transcripts directly to the Office of Admissions at Eastern Oregon University. Applicants with foreign transcripts see enclosed Transfer Admission Policy and Procedures. For additional colleges, please attach a separate sheet.

Enrolled

From To

School Name City/State/Country Mo Yr Mo Yr

Degree received and

credits completed

Examination information: Identify the test you have taken or plan to take and the dates you did take or will take them. Please self report your scores or attach an official copy of your results here.

TOEFL _____ Date __________ Score _____ IELTS _____ Date __________ Score _____

Canadian students only/COFA optional:SAT Reasoning _____ TSWE _____SAT I _____ SAT II _____

V _____ M _____ V _____ M _____Test _____ Score ____ Test _____ Score _____ Test _____ Score _____

Citizenship

Country of citizenship: _______________________________________________

Country of birth: ______________________________________

Native language: ___________________________________________________

For international students only

Current U.S. visa you now hold:

Student (F-1) _____ Exchange Visitor (J-1) _____ Other _____ None _____

If you hold a U.S. visa issued by SEVIS (Student and Exchange Visitor Information System):Are you entered in SEVIS? r Yes r No If yes, what is your SEVIS number? N___________________________________________Are you currently in status? r Yes r NoWill you leave the U.S. for 5 months or more between studies? r Yes r No

If your spouse and/or children will accompany you to EOU, provide on a separate sheet their name, date of birth, country of citizenship, country of permanent residency, city and country of birth and relationship to you. Please provide a copy of each accom-panying you their identification pages in their passports.

**EOU Legacy: Did anyone in your immediate family attend EOU? r Yes r No

_____________________________________________________________________________________________________________Name Relationship Year Degree earned

Did your parent(s) complete a 4-year college education? r Yes r No

**Activities you plan to be involved in at EOU: r Music performance r Theatre r Student newspaper r Student government r Outdoor programs r Varsity athletics (specify sport) _____________________ r Other ________________________________

**How did you learn about EOU? ___________________________________________________________________________________

Signature requiredI certify the information on this application is correct and complete. I understand that withholding records of academic work or giving false information is grounds for dismissal or denial of admission. I also understand that, whether or not I enroll, this application and all other submitted documents will not be returned to me. (Please sign in ink. This application is valid for one year prior to matriculation.)

Signature: _____________________________________________________________________________________________________Applicant’s signature Date

r My $90 application fee is attached (international students only)

r My $50 application fee is attached (COFA students only)

Eastern Oregon University is committed to providing equal education opportunities to all qualified students without regard to race, color, sex, national origin, age, religion, marital status, disability, veteran status, sexual orientation, gender identity or gender expres-sion. Direct related inquiries to the Affirmative Action Office, One University Blvd., La Grande, OR 97850; telephone 541-962-3548.

**This information will not be used for making admissions decisions. However, you are encouraged to provide this information for data collection, application processing and research purposes.

* Social Security Number Disclosure and Consent StatementAs an eligible educational institution, EOU must receive your correct social security number (SSN) to file certain returns with the IRS and to furnish a statement to you. The returns EOU must file contain infor-mation about qualified tuition and related expenses. Privacy Act Notice—Section 6109 of the Internal Revenue Code requires you to give your correct SSN to persons who must file information returns with the IRS to report certain information. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. For more information please refer to IRS code 6050S. You will be issued a student ID number for your academic record at Eastern.

12/02/2016