INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
[Link]/international
For Green River offce use only:
PLEASE SUBMIT YOUR APPLICATION CHECKLIST: 84492- Received:
years of age by program start
APPLICATION TO: q Applicant must be at least 16 date.
International Programs ❏ Completed application
Green River College ❏ Financial statement – Offcial bank letterhead in English showing enough funds for
12401 SE 320th Street one year of study at Green River (see website for current amount).
Auburn, WA 98092-3622 USA
❏ $50 non-refundable application fee
Phone: 1 (253) 288-3300
Email: international@[Link] ❏ Housing choice (16-year-old students are required to live with a Host
Family until Apply online: [Link]/international they turn 17 years of age).
❏ $300 Housing placement fee
Brochure: [Link]
❏ Copy of
Virtual Tour: [Link]/tour/greenriver
passport
Facebook: [Link]/grcciis ❏ Transcript from last school attended, sealed by school (highly
recommended)
Twitter: [Link]/grccip
❏ For transfer students only: Transfer-In Form (available by request or on
website),
Instagram: [Link]/ipgreenriver copies of current visa and I-20 and transcripts.
IP1704Applic
INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
PERSONAL INFORMATION
q New student q Transfer studentq Returning Green River student Date of birth:
month
/ day
/ year q Male q Female
Last name (family, as it appears on passport):
First name (given, as it appears on passport):
Middle name(s), if any:
Country of birth: Citizenship:
Native language: English ability: q Fluent q Average q Poor
Visa type: q F-1 student q M-1 student q J-1 student q Other
Which of the following best describes you: q No children (13) q Married with children (12) q Married with no
children Do you have any medical conditions or allergies? q No
q Yes, describe:
Do you require any special physical or learning assistance? q No q Yes, describe:
How did you hear about Green River College?
q Web search ❏ Green River College website ❏ "Study in the USA” website
❏ Social media ❏ Study Abroad Fair ❏ Friend, relative or current Green River student ❏ Other:
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Green River College is an equal opportunity educator and employer. Learn more at [Link]/accessibility.
[Link]/international
CONTACT INFORMATION:
Student: Parent’s names (Last/family, First):
Home country address: Mother:
Father:
Current address: Current address:
Phone: Phone:
Email: Email:
Emergency contact: Emergency contact phone:
Agency Name:
Where would you like your I-20 sent?
❏ Home country address ❏ Current address ❏ Agency/Advising center (provide address)
❏ Other (provide address)
Agency/Advising center or other mailing address (if applicable)
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Green River College is an equal opportunity educator and employer. Learn more at IP1704Applic
INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
Agency Name: Agency contact person:
Address:
Phone: Fax: Email:
FINANCIAL INFORMATION:
How will you pay for your tuition and living expenses?
❏ Personal funds ❏ Family funds ❏ Government sponsorship from home country ❏ Company sponsorship from
home country ❏ Sponsor within the U.S. (I-34 required) ❏ Other
If your application is accepted you will need to pay the following fees:
$50 Application fee (non-refundable)
$300 Housing placement fee (refundable upon request up to two weeks before move-in day)
Payment Options:
1. Online at [Link] or
2. Bank wire transfer to: Green River College, International Account No. 153504623387, SWIFT code:
USBKUS44IMT
U.S. Bank, 401-15th Street NE, Auburn, WA 98071
ABA No. 125000105
Student Name (must be included with wire information)
Green River Student ID Number (if known)
Important! Send an e-mail to international@[Link] with student name, date of birth, amount of money and
date wired.
[Link]/accessibility.
[Link]/international
EDUCATION:
How much schooling have you had prior to attending Green River College?
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Green River College is an equal opportunity educator and employer. Learn more at IP1704Applic
INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
❏ No high school diploma (11)❏ High school diploma (13), month and year of graduation:
❏ Associate degree (16) ❏ Bachelor’s degree or above (17) Name of
school you are currently attending or school last attended:
TOEFL score: Date: IELTS score: Date:
When would you like to start at Green River College?
❏ Fall/Sept. ❏ Winter/Jan. ❏ Spring/March ❏ Summer/June Year:
What will you study? Check all programs that relate to your studies at Green River College.
You may check more than one box.
❏ University Transfer ❏ Intensive English (IEP) ❏ High School Completion ❏ Gap
Year/Study Abroad ❏ Associate Degree ❏ Certificate ❏ Special program, which one?
What subject (major) do you plan to study?
Approximately how long will you attend Green River College?
❏ One quarter (11) ❏ Two quarters (12) ❏ One year (13) ❏ Two years (14) ❏ To complete a degree (15) ❏
Don’t know (16)
University Transfer Pathways: A letter of admission to a 4-year university may be requested at the same time
you apply for Green River College. Go to [Link]/international/university-transfer-pathway for the most
recent list of UTP universities. ❏ Yes – I request a UTP letter of admission to:
Please fll in name of UTP university
HOUSING
❏ I will find my own housing (provide your U.S. address if known):
IP Housing requires 16-year-old students to live in a vetted and approved host family for the period of 1 quarter at a
time until they turn 17 years of age. Housing placements for 16-year-old students will be given first priority for host
family placement. Housing placements for students 17 years old or older are made in the order completed
applications and placement fees are received. Preferences are met based on availability.
Green River has two housing choices for new applicants, Campus Corner Apartments or Homestay. What is your
preference? Choice #1:
Choice
#2:
HOMESTAY APPLICANTS COMPLETE THIS SECTION
This information will be provided to your prospective Host Family.
What type of family do you prefer? (You may check more than one box.)
❏ Family without children ❏ Family with international students ❏ Family with small children ❏ Family with teenagers Are
there foods you cannot or will not eat? ❏ Yes ❏ No What foods?
Do you smoke? ❏ Yes ❏ No ❏ Sometimes
Do you have any religious requirements or preferences?
CAMPUS CORNER APARTMENT APPLICANTS COMPLETE THIS SECTION
This information will be provided to CCA. Placements are made first-come, first-served. Preferences are met based on
availability.
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Green River College is an equal opportunity educator and employer. Learn more at IP1704Applic
INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
I prefer: ❏ Females only ❏ Males only ❏ No Preference I prefer to share with: ❏ International
students ❏ Domestic (American) students ❏ Both
[Link]/accessibility.
[Link]/international
SIGNATURE PAGE FOR PARENTS AND STUDENTS International Student Admission Policy
New students who use Green River’s I-20 to enter the U.S.A. must: Report in person to Green River’s orientation for new
international students; Enroll for and attend the first quarter at Green River; Carry Health Insurance while enrolled at
Green River; Present originals of: passport, visa, and Green River’s I-20 - Students transferring from other U.S. schools
must present their most recent I-20.
Medical Release
The undersigned hereby gives to Green River College, its officers, employees, agents, and host families full authority and
permission to take whatever action they feel is reasonably warranted under the circumstances, and to act as agent of the
undersigned student and parent/guardian, regarding the named student’s health and safety. This authority and permission
includes, but is not necessarily limited to, the following: Rendering or ordering medical treatment; the giving of medication;
and any examinations, X-rays, anesthetic, medical or surgical diagnosis or treatment or hospital care, if and as deemed
necessary. The undersigned understands that a reasonable attempt will be made to contact the undersigned
parent/guardian before any action is taken. The undersigned agrees to be financially responsible for all medical attention
so authorized or ordered during the student’s attendance at Green River College. The undersigned represents that the
named student has no medical restriction that limits his/her full participation in the programs and activities of Green River
College, except as disclosed in any writing attached to this document. Permission is given for the student to participate in
all activities offered at Green River College, except as restricted in any attached writing. To the fullest extent permitted by
law, the undersigned hereby releases Green River College, its officers, employees, agents, and host families from all
liability, and waive and release all claims, related to or arising from such decisions or actions as may be taken under the
authority of this document.
Photograph/Image Release
I consent to each use by Green River, and its officers, employees, and agents, of any photograph and likeness of me.
Such use may include, but aren’t limited to, use in a program, catalogue, schedule, newspaper, web site, brochure,
advertisement, or other publication or recording that describes, portrays, publicizes, or advertises the college or any
college operation, and every reproduction, republication, or other re-use of the same. I also hereby waive any right to
compensation for such uses, and any right to inspect or approve the uses beforehand. I hereby release Green River, its
legal representatives and all persons acting under its permission or authority, from any liability by virtue of any blurring,
distortion, alteration, optical illusion, or use in composition form, whether intentional or otherwise, that may occur or be
produced in taking of said image.
The information you provide is voluntary. However, if you do not provide the information requested your application
will not be processed. This information will be used at GRC and the Washington State Board of Community and
Technical Colleges, and will be shared with U.S. Immigration and Customs Enforcement per their Student and
Exchange Visitor Program requirements.
By my signature below (Please check the following boxes):
❏ I verify that, to the best of my knowledge, all of the statements on this application form are true. I have read and agree
to the published International Student Admission Policies.
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Green River College is an equal opportunity educator and employer. Learn more at IP1704Applic
INTERNATIONAL PROGRAMS
INTERNATIONAL STUDENT APPLICATION
12401 SE 320th Street, Auburn, WA 98092 USA • 1 (253) 288-3300 •
❏ I authorize Green River College to release academic and immigration records to my educational agency and or parents.
❏ I consent to use by Green River any likeness, image or photo of me for any official college program.
❏ I am either 16 or 17 years old and my parent/legal guardian must sign this form to complete my
application.* ❏ I understand this disclosure and authority as it relates to the General Data Protection
Regulation (GDPR).
Student’s name (please print): Age: Birthdate: / /
month day year
Student Signature: Today’s date: / /
month day year
*Parent/Legal Guardian’s Name (please print):
*Parent/Legal Guardian’s Signature: Today’s Date: / /
month day year
[Link]/accessibility.
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Green River College is an equal opportunity educator and employer. Learn more at IP1704Applic
