Central State University
International Student Application for Admission

Personal Information

Date of Birth (mm-dd-yyyy) Gender Male Female
Name of Parents or Guardians Father:
Permanent (Home) Address:
Mailing Address
(if different from Home address):
Phone Number (Number Only)
Country of Birth Country of Citizenship
Type of visa you hold (if any):
Are you a permanent resident of USA? Yes No if yes, Legal Alien Number:
Are you a Resident of Ohio? Yes No if yes, how long: From to County:

Do you intend to come to the US with dependents (spouse/children)? Yes No

if yes.... list dependent(s):
Dependent's name: Relationship:
Dependent's name: Relationship:

Enrollment Plan

Term you are applying for: Fall (August)   Spring (January)
Major:    Minor:
Degree Type: Bachelor's Master's    Applying as: Freshman Transfer Graduate

Central State University

Declaration and Certification of Finances
(for international students only)

A Certificate of Eligibility (Form I-20) will not be authorized until this form is completed and returned. When all admissions criteria have been met, a copy of this form will be attached to the I-20. Both must be shown to the U.S. Consulate for issuance of the visa.

Estimated General Expenses for the Undergraduate
2018-2019 Academic Year

Tuition $ 3,926
Instructional Fees $ 2,320
Out of State Surcharge $ 1,850
Room Charges $ 5,340
Board Charges $ 4,594

Books & Supplies

$ 1,700
Health Insurance $ 1,630
TOTAL Yearly Cost $21,360


Official Verification of Sources of Funds and Amounts

First Year Source(s) of Funds (U.S. Dollars Only)
a) Student's Personal Funds:
b) Funds from Family:
c) Sponsor (please specify):


Subsequent Year Source(s) of Funds (U.S. Dollars Only)
a) Student's Personal Funds1:
b) Funds from Family:
c) Sponsor2 (please specify):



1. Student's Personal Funds: If personal funds are being used for subsequent years of study, funds must be documented and available.
2. Sponsor: If your sponsor is in the US, you must have him/her complete and submit a Form I-134.



Click below to download the Bank Certification Form (to be filled out by your bank) and the Financial Certification Form (to be filled out by your sponsor). Print and have each form filled out completely and signed. Mail the forms and other official documents to:

Central State University
Office of Admissions
PO Box 547
Wilberforce OH 45384

Bank Certification Form

Financial Certification Form


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