Please verify and edit if necessary the information below is correct before submitting your application for admission.

STUDENT INFORMATION

Surname/Primary Name: *

Given Name: *

Middle Name:

Preferred Name:

Date of Birth: * (MM/DD/YYYY)

Gender: *
Female Male

Marital Status: *
Married Unmarried

Country of Citizenship: *

Country of Birth: *

Student Contact Information

This section must indicate the students' personal contact information for admission.

Telephone Number (include country and city code): *

Fax Number (include country and city code):

Email Address: *

Application update notifications will be sent to your email address.
Agency emails should NOT be entered in the email address field.
With the student's permission, agents will be able to provide their contact information later in the application process.

Home Country Address: *

No P.O. Box or Agency addresses in this section.

Please keep us informed of any changes in your address(es).

VISA INFORMATION

Are you currently inside the United States? *

Yes No

Passport Number:

Passport Expiration Date: (MM/DD/YYYY)

DEPENDENT INFORMATION

Do you have any dependents coming with you? *
Yes No

TRANSFER INFORMATION

Are you a transfer student? *
Yes No

Do you plan to travel outside of the U.S. prior to beginning your studies at LBCC? *
Yes No

EDUCATIONAL INFORMATION

Semester you are planning to attend: *

Summer admission is only available for ALCI applicants.

I am applying for admission to: *

What will your major field of study be? *

Education History

List all Secondary Schools and Higher that you have attended:

FINANCIAL INFORMATION

A financial bank statement or bank letter prepared by the bank must be submitted with your complete application from your personal account or family sponsor. The funds must be in a liquid account with NO maturity date or withdrawal restrictions. The bank statement or bank letter must be current and no less than three (3) months old.

Financial Support is From: *

Student/Self

Family sponsor

Home Government

GENERAL INFORMATION

What languages do YOU read and/or speak?: *

How did you learn about Long Beach City College?: *

Why did you choose Long Beach City College?: *

RELEASE INFORMATION

Family Educational Rights and Privacy Act (FERPA): All student records of Long Beach City College are maintained in accordance with the provisions of the Family Rights and Privacy Act of 1974.

I hereby give permission to Long Beach City College to release information concerning my student admission status to the following person(s). (Optional):

Father:

Mother:

Sponsor:

Guardian:

Agent Information (if applicable)

Name:

Telephone Number (Include country and city code):

Email Address:

How would you like to receive your LBCC admissions packet? *
Pick Up - Self Mail to Home Country Address Mail to U.S. Address

REQUIRED DOCUMENT UPLOAD

CERTIFICATION INFORMATION

*-Denotes a required field