Foreign Student Application

Only fill out this application if you live outside the United States.

* Indicates a required field

Personal Information

Prefix:
 * First name:  
Middle name:
* Last name:  
Suffix:
* Preferred name:  
Social Security Number:  if you do not have an SSN please leave this field blank

Demographic Information

 * Gender:  
Ethnicity:
Marital Status:
Religious Affiliation:
Veteran Status:
* Birth Date: Day Month Year
Have you ever been officially reprimanded by school officials or civil authorities?

If yes, please explain:

Contact Information

* Physical Mailing Address:  
* Email Address:  
Home Phone:
Mobile Phone:

Citizenship Information

* Primary Citizenship:  
Visa:

Enrollment Information

* Please indicate the term and year you wish to enroll at YHC  
* Please indicate your intended degree and major  
* Where do you plan to reside
Please indicate your status
Who influenced your application

Name

Activities

What activities have you been involved with in the following areas:
  • Academic
  • Church
  • Community
  • High School
  • Sports
Please separate each activity by a comma.

Family Information

Father's information
Name
Address
Phone number
Email
College
Occupation
Employer
Mother's information
Name
Address
Phone number
Email
College
Occupation
Employer
   
Please list names and ages of siblings dependent on your parents:

High School Information

* Institution name:  
Address:
* Graduation Date: Day Month Year

Transfer / Transient Student Information

This section is for transfer or transient students only. Please list the current or last college/university you attended.

Institution name:
Addres:
Graduation Date: Day Month Year