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MOREHEAD STATE UNIVERSITY
International Undergraduate Admissions Application
Office of Enrollment Services 100 Admissions Center Morehead, KY 40351
?

Phone: (606) 78

3-2000 or 1-800-585-6781 Fax: (606) 783-5038 E-mail: admissions@moreheadstate.edu

www.moreheadstate.edu
________________________________
Social Security Number country country zip zip

Please print or type, sign, date and return to MSU.

Section A
Legal name_______________________________________________________________________
family street street first city city middle region region

Permanent address____________________________________________________________________________________________________ Present/current address________________________________________________________________________________________________ E-mail address________________________________________ Fax No.______________________________ Enrollment type (check one): q Freshman q Transfer q Returning q Asian/Pacific Islander Dual citizenship: q Yes q No

Phone number___________________________ Sex: q Male q Female Ethnic origin (required for federal reporting purposes only):
month day

q Black q American Indian q Hispanic q Caucasian (white) _???????????????______ _____ Date of birth: _____ _____ _____ _____ Resident alien: q Yes q No Marital status: q Single q Divorced q Married
year

q Widowed q Associate q Baccalaureate q summer II July ______

Major___________________________________________ and degree objective:
program area of interest

Plan to enroll:

q fall August ______

q spring January ______

q summer I June ______

High school/secondary school___________________________________________________________________________________________
name city country

Graduation date: ____/____
month / year

TOEFL q Yes Michigan q Yes q father

q No q No

date taken___________ date taken___________ q spouse

ACT SAT

q Yes q Yes

q No date taken___________ q No date taken___________

Nearest relative:

q parents

q mother

q guardian

Relative’s name______________________________________________________________________________________________________
family permanent address first city region middle country

Relative’s address_____________________________________________________________________________________________________ Have you previously attended Morehead State? q Yes (date ______ to ______) q No

If yes, other name(s) under which your records may be filed____________________________________________________________________ Other colleges or universities attended (if applicable):
Name of Institution Address Dates

__________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ Have you ever been convicted of a criminal offense other than a traffic violation? q Yes q No If yes, explain_______________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________

Section B
Country of birth____________________________________________ Country of nationality_____________________________________ Type of visa currently held________________________________________________________________ The U.S. dollar sum you have available for each year of study_________________________________ Mark and provide documentation of financial resources: (A) Personal or family (B) Family overseas (C) Funds from another source (specify type/source) ______________________________ ______________________________________________________________________ $ _________________________ $ _________________________ $ _________________________ Total $ _________________________

Important: Certified letter(s) and/or affidavits should accompany this form--including bank, employment, governmental, or sponsorship statements.
List name(s) of spouse and/or children coming with you: Name Age Relationship

__________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________

Morehead State University may, from time to time, desire to use my photograph and/or personal data, including academic records, for publicity purposes for the University. I have read the above statement and understand it, and hereby state that I do not object. (If you do object, you must notify the Media Relations Director in writing at 350 University Street, Morehead, KY 40351.) I agree to adhere to the rules and regulations of the University and certify that all statements in this application are true. I also understand that any misrepresentation of information will make me ineligible for admission to Morehead State University or subject to dismissal after admission has been granted.

Applicant’s signature______________________________________________________________________ Date_______________________

The following documents must be submitted: 1. Official undergraduate transcript(s) of prior educational work and an evaluation of the transcript(s) from World Education Services (WES). 2. Official TOEFL/ACT or SAT scores. 3. Official documentation that you will have at least $23,252 per academic year. 4. $30 U.S. application fee payable by credit card or U.S. money order. Enclose a money order or provide the charge informaton below: q MasterCard q Visa q Discover q American Express Expiration date____________ Cardholder’s Signature________________________________________________
Morehead State University is an affirmative action, equal opportunity, educational institution.


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