California State University, Fresno
International Admissions, 256 Joyal Administration Building, M/S JA 56
Fresno, California 93740-8026 U.S.A.
(559) 278-2782 Fax • (559) 278-7011 • Electronic Mail: intladmissions@csufresno.edu
INTERNATIONAL APPLICATION
Please type or print clearly. Please complete all sections.
A non-refundable Application Fee of $70 USD must accompany this application
Personal Information
N
ame (as on passport):
Full Legal Family/Last Name First/Given Name Middle Name
Birthdate (month/day/year): Gender: Male Female
Country of Birth: City of Birth:
C
ountry of Citizenship:
C
ountry of Nationality:
Current Mailing Address (if US, no P.O.BOX): Permanent Street Address (in your country):
Address Address
C
ity State Country Postal City State Country Postal
Email Address:
Application
Sem
ester applying for (check one term only) Fall Spring Year
Intended Degree: Undergraduate Graduate Exchange Non-Degree
I
ntended Major:
I
ntended Option:
H
ave you ever applied to California State University, Fresno before? Yes No
Have you ever atten
ded C
alifornia State University, Fresno before?
If yes, ID# used and Name:
If yes, please
write the last semester/term you attend:
Yes
No
Educational History
Please complete accurately and completely the instructions for each numbered column below.
Dates of Attendance
Full Name of School
Type of School
Location of School
(City, State, & Country)
Name of
Certificate/ Degree
& Date Earned
Month/Year
High School:
College:
CERTIFICATION - to be read and authorized by all applicants to certify the accuracy of the information provided.
I certify under penalty of perjury under the laws of the State of California that I have provided complete and accurate responses to all
the items on this application. I further certify that all official documents submitted in support of this application are authentic and
unaltered records that pertain to me. I authorize the California State University to release any information submitted by me in this
application for admission and any application for financial aid to any person, firm, corporation, association, or government agency to
verify or explain the information I have provided or to obtain other information necessary for my application for admission and any
application for administration of financial aid and in connection with any perjury proceedings. I authorize the California State
University system to release any submitted test results to all campuses to which I submit an application. My certification verifies the
accuracy and completeness of the information provided. I understand that any misrepresentation or omission may be cause for denial
or cancellation of admission, transfer credit, or enrollment. I certify that so long as I am a student at this institution, I will advise the
residence clerk if there is a change in any of the facts affecting my residence.
I agree to meet the California State University comprehensive health insurance requirement for the duration of
studies/practical training as listed on my I-20 or DS-2019 form.
Signed at
Country Applicant's Signature Date
Nondiscrimination Policy-- The California State University does not discriminate on the basis of race, color, national origin, sex, physical
handicap or sexual orientation in the educational programs or activities it conducts.