Application for International Students

Application for International Students

A $50.00 (U.S. currency) non-refundable application fee must also be submitted to: Stacy Gee, International Student Advisor, 1109 West Panola, Carthage, TX, 75633
Email*
example@example.com
Social Security Number (number will be assigned at Panola College for new students; transfer students should use their original number)
Enrollment
What semester do you plan to enroll at Panola College?*

FallSpringSummer ISummer II
What year do you plan to enroll at Panola College?*
Select all that apply*

First time to attend Panola CollegeTransfer from a U.S. collegeOnly attend in the summer months
Personal Data
Name (give full legal name. do not use initials unless initials are your legal name)*

First NameMiddle NameLast Name
Permanent Mailing Address in Your Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*
Home Phone in Your Country*
Business Phone in Your Country*
Birthdate*

MonthDayYear
Date
Birthplace (city and country)*
Country of Citizenship*
Person to Notify (in case of an emergency)*
Home Phone for Emergency Contact*
Business Phone for Emergency Contact*
Name, Address, Phone Number, and Email of a Friend or Relative in the U.S. (if applicable)
Educational Data
Level of School Completed*
City of School*
Country of School*
Date of Graduation*

MonthDayYear
Date
College Major at Panola College (the name of the subject area you will study)*
Degree Held (if any)
College Record

If you have attended a U.S. college before, complete the section below and provide official transcripts (include current enrollment and hours in progress)
College Attended
City and State
Semester/Year Attended
Semester Hours Earned
Oath

I certify that all information on this application is complete and correct, and I understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment, or appropriate disciplinary action. I further understand that Panola College reserves the right to refuse admission to any international student if it is not in the best interests of Panola College or the United States of America.
Date*
Signature*

Clear
Please verify that you are human*
Should be Empty:

Application for International Students

Enrollment

Personal Data

Educational Data

College Record

Oath