International Undergraduate Application

Undergraduate application for International students.

Identification
Last Name (Surname/Family Name) *

Surname/family name
First Name (Given) *
Middle
Social Security Number

If applicable.
Birthdate * / MM / DD YYYY
What other names are you known by?

Preferred name, maiden name, etc. This is not required.
Gender * Female Male
Race (optional)

For Federal/State reporting purposes only. This information will be used in a non-discriminatory manner consistent with civil rights laws.
Mailing Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Residence Information
Country of citizenship *
Type of Visa that you are seeking
Alien Registration Number

if applicable
Date of Issuance / MM / DD YYYY
International Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Information
Email Address *
Home Phone *
Work Phone
Birth Place
City of birth *
Country of birth *
Parent/Guardian Information
Parent or Guardian?
Name

Enter the name of your parent or guardian.
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Enter the address of your parent or guardian.
Education
TOEFL or IELTS score
Name of secondary school last attended *
Address of most recently attended secondary school
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Secondary education level *
Date Received / MM / DD YYYY
Enrollment Term *

What semester do you expect to start SAU?
Enrollment Year *

What year do you plan to attend SAU?
Are you seeking a degree at SAUM? *
Specify major *
Do you want to enter the Intensive English Program prior to your degree coursework? *
Are you seeking a teaching certification?
Are you seeking re-certification?
Are you presently on suspension/probation from any college or university? *
If so, please explain in detail below:
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? *
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:
Classification * 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 enrolled in other colleges/universities. Non-degree seeking (but enrolled for professional development/ personal interest).
Please select your classification.
Do you plan to live on campus? *

Please indicate whether or not you plan to live on campus.
Did your parents attend SAUM? *

Please indicate whether or not your parents attended SAUM.
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.
School 1- Name

Please list the first school attended
School 1- Location
School- 1 Dates Attended
School 1- Degree Obtained
School 1- Hours Earned
School 2- Name
School 2- Location
School 2- Dates Attended
School 2- Degree Obtained
School 2- Hours Earned
School 3- Name
School 3- Location
School 3- Dates Attended
School 3- Degree Obtained
School 3- Hours Earned
School 4- Name
School 4- Location
School 4- Dates Attended
School 4- Degree Obtained
School 4- Hours Earned
Verification and Submission

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. 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. To send this form please click the button ONE time.
Type the letters you see in the image below.

International Undergraduate Application

International Undergraduate Application

Identification

Residence Information

Contact Information

Birth Place

Parent/Guardian Information

Education

Disciplinary (information required):

Transfer Students Only

Verification and Submission