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Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802Instructions for Application and AdmissionTIMELINESTo allow time for the exchange of correspondence, processing and evaluation of your academicrecords, please return your application by June 15th, for the fall (August-December) semester andOctober 15th, for the spring (January – May) semester.FINANCESInternational students must have sufficient funds immediately available to pay tuition and fees inadvance. Bank verification of funds available to cover one year’s financial need must besubmitted with the application.**Students are encouraged to pay in full upon registration**ENGLISHFor those students whose primary language is not English, they must show oral and writtenproficiency in the English language using the Test of English as a Foreign Language (TOEFL)or International English Language Testing System (IELTS), or you may use Duolingo Testing.Minimum score of 75 is required for Duo lingo. Minimum TOEFL scores are 500 (paper-basedtest), 173 (computer-based test), and 61 (internet-based test). Minimum IELTS band score is 6. 3International students who score below the minimum required levels will not be acceptedACADEMIC PROGRAMInternational students must enroll in a full-time program with 12 or more units each semester.Failure to maintain a full course of study may lead to dismissal from Lassen Community Collegeand termination of your I-20.FOREIGN COURSEWORKStudents who have satisfactorily completed courses from a foreign nation’s appropriatelyaccredited university may be able to apply the course credits toward an Associate degree atLassen Community College. Students should consult a counselor BEFORE requesting to havecredits evaluated, because the time it takes to evaluate a large number of units can delayenrollment. Please note: Foreign coursework will not satisfy requirements for AmericanHistory/Government, English or reading.1
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802HEALTH STATUSInternational students must provide medical documentation including evidence of polio immunization orSabin oral vaccine, medical statement of immunization against measles, and a certificate of freedom fromactive tuberculosis. International students must provide verification of personal medical insurancecoverage. Students not currently covered for personal medical insurance coverage must purchasecoverage for the duration of their enrollment at Lassen Community College.HOUSINGIt is recommended that international students live in the Lassen Community College dormitory orother approved housing for their first year.EXPENSESCost of Attendance per Academic Year, based on 12 units per semester:Enrollment Fees:Books & Personal:Housing:Total: 9,098 4,500 3,500 17,098**Cost of attendance is subject to change**COVID-19 vaccination requirements will be in effect beginning 11/8/21.Effective November 8, 2021, all non-immigrant, non-citizen air travelers tothe United States will be required to be fully vaccinated and to provide proofof vaccination status prior to boarding an airplane to the United States. Linkbelow for your ersto-the-us.htmlADDITIONAL CONTACT INFORMATIONPhone: 530.251.8808 Email: lccadmissions@lassencollege.edu2
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Legal Name (onTelephone: (530)251-8808Fax: (530)251-8802passport):LASTFIRSTBirth date:**Month/Day/Year**Male:Middle NameFemale:Mailing Address:City:Country: Phone:Email Address:Country of Citizenship:Country of Birth:Are you a U.S. Citizen?California Resident?Do you have a current Visa?Visa Number:Resident Visa?Student Visa?Other?Date of Issue:Date of Expiration:Primary Language:When do you plan to attend?Fall:Spring:Other Language:Other:Proposed Major: Minor:Person to Contact in case of emergency:Name:Address:Home Phone: Work Phone:3
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802AGREEMENT WITH LASSEN COMMUNITY COLLEGEIn order for your application to be processed, the following agreement must be signed. You will beexpected to abide by these conditions of enrollment. If at any time you fail to meet one or more ofthese conditions, you may be subject to dismissal. Lassen Community College is required to reportstudent status to the United States Immigration and Customs Enforcement Office each and everysemester.The conditions are as follows:1. I will attend the orientation program for New Students.2. I will enroll in the courses selected for me by the International Student Counselor.3. I will maintain enrollment in a minimum of 12 units per semester and will remain ingood academic standing with a 2.0 GPA or better (Grade Point Average).4. I will maintain a current health insurance policy during my entire stay at LassenCommunity College.5. I will authorize the International Student Counselor to contact my instructors in orderto monitor my academic progress.6. I understand that if I violate any of the above conditions during my stay at LassenCommunity College I will be subject to probation or dismissal.Printed Name:Signature4Date
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802CERTIFICATE OF BALANCEInternational students must have sufficient funds immediately available to pay tuition andfees in advance. Bank verification of funds available to cover one year’s financial needmust be submitted with the application: 17,098.Name of Student:Name of Sponsor:Relationship to Student:Address:This is to certify that the above-mentioned person has the following amount of money inour bank. Convert foreign currency into U.S. Dollars.Type of AccountBalanceRemarksThe above statement is true to the best of my knowledge.Name of Bank:Address of Bank:Bank Officer’s Signature *required*5Date
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802HEALTH FORMName:Birth date:Address:Male:Female:Health History:IllnessesOperationsDo you have any of the following?Diabetes: YESNORheumatic Fever: YESEpilepsy: YESNOAsthma: YESNONOAllergies to:Food (which ones?):Drugs (which ones?):Other:Signature of StudentDate(Health form continued on next page)6
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802**All immunizations stated on this form are required**This portion must be completed and signed by a physician or public healthofficer.HEALTH FORMImmunization record for:(Name)Dates of Immunizations:Mumps: Measles: Rubella:Diphtheria:Polio: Tetanus:Pertussis: Influenza HepatitisTuberculosis, PPD result MMS: Date given:Chest X-ray date *required*:Results:Has the applicant had BCG?Covid-19 vaccine date given: **Required**All test results must be verified by a physician or public health officer before the student will beaccepted.Is the applicant clear of any communicable disease?Are there any special instructions regarding the physical/mental health of this individual?Address:Signature of Physician or Public Health Officer *required*7Date
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802MEDICAL INSURANCE AFFIDAVITI, (name) , hereby submit the evidence of Health andMedical Insurance. This insurance will cover the usual and normal costs, which I mightincur due to accident and/or illness while in attendance at Lassen Community College:Name of Insurance Company:Address of Company:Policy Number:Policy expiration Date:I, (name) hereby agree to purchase, prior to myinitial registration, a Health and Medical Insurance policy at my own cost. I will presentevidence of compliance to the Admissions and Records Office before I am allowed toregister for classes. Failure to do so will result in my dismissal from Lassen CommunityCollege.Student’s Name (print):Student’s Signature8Date
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802EDUCATIONAL BACKGROUNDList all secondary schools, colleges, universities, vocational and technical schools you have attended.Name of SchoolCountry/StateDatesMajor/DegreesWhat will be your primary goal in attending Lassen Community College? (Please checkany that apply to you.)Associate of Arts or Associate of Science DegreeVocational/Technical CertificateEarn credits/units for transfer to another U.S. college/universityEarn credits/units for transfer to a college/university in my home countryTo become more proficient in EnglishOther goals or objectives:List Tests of English you have taken and score:Date:Score:What other languages, besides English, have you studied?LanguageYears StudiedLevel of Speaking9ReadingWriting
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802EDUCATIONAL GOALSPlease write a short statement of your educational goals, describing how you might useyour education in your future endeavors, after completion of your college courses.Housing preference:First semester:On–campus dormitory:Host family home:Second Semester: On-campus dormitory:Host family home:Off-campus apartment:Other:I certify that all the information of this application is correct, and I realize that false or incompleteinformation may result in dismissal. I understand the rules, regulations and policies outlined in theLassen Community College catalog and agree to abide by themStudent’s SignatureDate10
Lassen Community College- International AdmissionsPO Box 3000, Susanville, CA 96130Telephone: (530)251-8808Fax: (530)251-8802To ensure your I-20 is received please provide us with your currentaddress and how it is written on an envelope below:11
Lassen Community College- International Admissions PO Box 3000, Susanville, CA 96130 Telephone: (530)251-8808 Fax: (530)251-8802 1 Instructions for Application and Admission . evidence of compliance to the Admissions and Records Office before I am allowed to register for classes. Failure to do so will result in my dismissal from Lassen Community
