Application          
    Please type all relevant sections, sign and return to your nearest study center:    
    Students Status    
    NAME─ (Last)        
      (Middle)        
      (First)        
    SEX─        
    Applicant's U.S. S.S.─ (OR I.D. Number)        
      Date of Birth─ ex-1976-03-15        
      Home Phone─        
      Office Phone─      
      Mailing Address─ (Zip-Code)      
               
      E-mail─        
      Country of Citizenship─  

 

    
      Native Language─  

 

    
      Program Choice
    
      Program Title─  

 

    
      Degree sought─

 

    
      Date you intend to  

 

    
      enroll─  

 

    
      Previous Education
    
      Please list all high schools, colleges, universities, and graduate schools you have attended, starting with the one you most recently graduated form:    
      Name of Institution Major Field Dates Attended Degree(s) Received or Expected & Date    
         
         
         
         
         
      Addtional Personal Data    
      Briefly describe your academic honors (prizes, scholarships, or membership in honorary societies); published works (scholarly or artistic); and leadership roles. List any academic artistic, professional, military, or community activities you consider significant to your proposed program of study    
      Date Details      
           
           
           
           
           
      Employment Record
   
      Name and Address of Employer Nature of Work Month/Year to Month/Year END    
         
         
         
         
         
      Personal Statement of Educational Objectives
    
      (To be completed only by these students applying for a Master's or Dorctorate degreee)
Personal statement of professional and educational goals:		    
           
 
 
 
 
 
      Signature:          
      Date: ex-1976-03-15        
               
                 
      Application Check List            
      Before submitting your application to the Regional Office, please check whether you have enclosed the following documents:
1. Completed application form.
2. Official transcripts of all post-secondary education, sealed in an envelope, signed and stamped with the school seal across the seal
3. Official degree certificate.
4. Two Recommendation Letters (Sealed)
5. Personal Statement of Professional and Educational Goals.
6. GMAT Score report (if applicable)
7. TOEFL Score report (if applicable)
8. Application Fee of US $100
9. Passport size photographs - 4
Applications will not be reviewed until all the above material and documents have been received.		      
                   
               
  Esquire 405 6th Avenue, Des Moines IA 50309, U.S.A / Tel：1-626-249-4025 / 1-623-239-0673  
 

Copyright © 1958 Southwest International University.  All Rights Reserved.

  
  All trademarks are registered property of the University. Used by permission only.