International Student
Admissions Application
Page 1 of 2 Rev Date 5.6.20
Applicant Identify Information
Full Name: _____________________________________________________________________________________
Last (Family Name) First (Given Name) Middle
Gender: Female Male Date of Birth (MM/DD/YYYYY):__________________________
Country & City of Birth: ______________________________________
Country of Citizenship/Passport-Issuing Country: _________________________________________________________
Passport Number: ______________________________________________________________________________
Permanent Home Country Address
Street Address (required): ________________________________________________________________________
Address Line 2: ________________________________________________________________________
City: ________________________________ State/Province/Territory: _____________________________________
Postal Code: _________________________ Country: ___________________________________________________
Current Mailing Address
(please update any address changes during the admissions process)
Street Address (required): ________________________________________________________________________
Address Line 2: ________________________________________________________________________
City: ________________________________ State/Province/Territory: _____________________________________
Postal Code: _________________________ Country: ___________________________________________________
Send I-20 documents to:
Permanent Home Country Address Current Mailing Address
I or an authorized family member/sponsor (authorization is granted through the signing of a FERPA Release
Form) will pick up my I-20 document from Nicolet College at the Rhinelander, WI campus.
Contact Information
Email Address: _____________________________________________________________________________________
Phone (please include country code): __________________________________________________________________
Academic Information
Intended Start Term and Year: Fall 20____ Spring 20____ Summer 20_____
Intended Program of Study* (Major): __________________________________________________________________
*
For information on the EMT-Paramedic (TD), Radiography (AAS), Pharmacy Technician (TD), or Pharmacy Services Management (AAS) please
email admissionsh@nicoletcollege.edu prior to submitting this form.
International Student
Admissions Application
Page 2 of 2 Rev Date 5.6.20
Academic Information (continued)
TOEFL Score: ________________________________ Exam Date (MM/DD/YYYY):_____________________________
Test Type: Paper-based Internet-based Computer-based
Accuplacer ESL Score: _________________________ Exam Date (MM/DD/YYYY):_____________________________
For persons already in the United States, please provide the following information:
What is Your Current Visa Status (F-1, etc.): _____________________ Issue Date: ____________________________
F-1 Visa Students:
What Institution Issued the I-20: __________________________________________________________
Current Institution: ________________________________________________________________________
B-1/B-2 Students, Visa Expiration Date: ________________________________________________________________
I certify that the information on this application is true and complete to the best of my knowledge.
______________________________________________________ ________________________________
Signature Date (MM/DD/YYYY)
Please mail this completed form, along with the following:
A copy of current passport
TOEFL scores or Accuplacer ESL scores, if applicable
Translated official high school transcripts
Evidence of Financial Support Form
$30 check or money order payable to Nicolet College
Estimated costs per year (based on 2020-21 academic year):
University Transfer/Liberal Arts
Occupational
Tuition
$5,844
$4,440
Room and Board
$6,678
$6,678
Books and Supplies
$1,654
$1,654
Transportation
$1,584
$1,584
Personal Expenses
$1,878
$1,878
Health Insurance
$1,000
$1,000
Total
$18,638
$17,234
For questions or more information please contact us:
Nicolet College, International Admissions
PO Box 518, 5364 College Drive, Rhinelander, WI 54501
E-mail: admissions@nicoletcollege.edu Telephone: (Country code 1) (715) 365-4464
Fax: (Country code 1) (715) 365-4901
nicoletcollege.edu
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