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Admission Required Document(입학서류)-(New Student)
Application Admission Form / 입학원서(소정양식) 1
Birth Certificate / 주민등록등본(영문) 1
Official Transcript of the previous attended school / 최종학교 성적증명서(영문) 1
Photocopy of Passport / 여권사본 1
Bank Statement / 은행잔고증명서(영문) $25,000.00 or above 1
Copy of Driver License / ID 카드 1
Application Fee: US Residents $100.00
International Students $200.00(Dependent $100.00)
Registration Process Document: Enrollment Agreement Insurance Policy
KERNEL UNIVERSITY Admission Counseling Department Tel: 714-995-9988/ Fax: 714-995-9989 info@kernel.edu
Revised: 08/20/2014
APPLICATION FOR ADMISSION
Enrollment Information
Programs B.Th. M.Div. D.Min. Major __________________________________________
Applying Year _____Winter _____Spring _____Summer _____Fall Year (20 )
Types of Application _____ Overseas (Students not in the U.S. without an F-1 visa)
_____ U.S. Transfer (Students currently in the U.S. with an F-1 visa)
_____ Change of Status (Students currently in the U.S. with a visa Other than F-1)
Personal Information
1. Name _____________________________________________________________________________________ Last (family name) First (given name) Middle
Other names under which any documents may be issued ________________________________________________
2. Birth date and place _____________________________________ Gender Male Female
3. Address Mailing Address/Foreign Address
Street ________________________________ (If different from current address 왼쪽 주소와 다른 경우)
City __________________________________ __________________________________________
State, Zip _____________________________ __________________________________________
4. Phone ______________________________ Mobile Phone _____________________________________
5. Email ______________________________________________________________________________________
6. Nation of Citizenship ______________________________________
U.S. Citizens do not need to answer 7, 8, 9. 미국 시민인 경우에는 7, 8, 9 번을 답을 하지 않으셔도 됩니다.
7. If you are not a U.S. Citizen, are you a resident alien? 영주권자 Yes No
8. Will you be applying for the I-20 to receive an F-1 Visa? 학생비자 발급을 위해 I-20 를 신청합니까? Yes No
9. If no, what kind of visa do you have? 기타, 비자 종류를 기재하십시오(F-1, F-2, H-1, R-1, B-1, B-2, other ___________)
U.S. Social Security Number (if applicable) _____________________________________________
Driver License Number (if applicable) __________________________________________________
10. Emergency Contact Name ________________________________________________________________
Street Address ________________________________ Relationship ________________________________
City, State, Zip ________________________________ Phone _____________________________________
Revised: 08/20/2014
Educational Background
ACADEMIC DATA: List chronologically all colleges, universities and other educational INSTITUTIONS ATTENDED SINCE HIGH SCHOOL,
INCLUDING THOSE OFFERING Extension COURSES (PLEASE INCLUDE THE INSTITUTIONS YOU ARE CURRENTLY ATTENDING).
The LAST ATTENDED INSTITUTION SHOULD BE LISTED LAST
Name of School College of University
Location (City, State and Country)
Entered (Month/Year)
Withdrawn (Month/Year)
Major/Degree
Reference Who will be supplying for your recommendations?
Name Phone Number Name Phone Number
CERTIFICATION TO BE READ AND SIGNED BY ALL STUDENTS TO CERTIFY THE ACCURACY OF THE INFORMATION PROVIDED.
Kernel University expects you to provide complete and accurate responses to the items on this application for admission. Further, the official documents that you submit in support of this application must be authentic, unaltered records that pertain to you. Your signature is your certification of the accuracy and completion of the information you provide. I certify under penalty of perjury, or after being duly sworn, that I have provided complete and accurate responses to the items on this application. I further certify (swear) that all official documents submitted in support of this application are authentic and unaltered records that pertain to me. I hereby authorize the release of any information submitted by me in connection with this application to any person, firm, corporation, association or government agency, but only to verify or explain the information, obtain pertinent records, or in connection with perjury proceedings. I certify (swear) that so long as I am a student at this institution, I will advise the residence clerk if there is a change in any of the facts affecting my residence.
Signature Date
Please Return to: KERNEL UNIVERSITY Office of Admissions and Records 3319 W Lincoln Ave.,Ste 201. Anaheim, CA 92801
OFFICE OF ADMISSION AND RECORDS
Reviewed By Signature/Date
Revised: 06/30/2013
Student Enrollment Agreement
Student ID#: ______________________________________________________________
Student Name: ____________________________________________________________
Last First
Total Tuition: $__________________________________
Registration Fee: $_______________________________
Student Scholarship: $____________________________
Tuition Discount: $_______________________________
Student Charges: $_______________________________
I have agreed and paid the total amount of the student charges to fulfill the enrollment as a full time
student at Kernel University.
________________________________________________ ___________________________________ Signature Date
Joanne C Lee
CFO
Revised: 06/30/2013
INSURANCE POLICY 보험 정책 Student's Name __________________________________ Student's ID No. ___________________________________
Date of Birth _______________________________________ Major __________________________________________________
Semester __________________________ Year _________________________________
I carry my own insurance. 본인은 보험을 소지하고 있습니다.
NAME OF INSURANCE COMPANY: _____________________________________________________________________
I do not carry my own insurance, however, I fully understand that Kernel University will not be
liable for any medical expenses in case of emergency or accidents I incur on the
school permises or during any school activities.
본인은 무보험자입니다. 그러나 대학캠퍼스내 또는 밖에서 본인에게 질병이나 사고 또는 부상 발생시 학교가 책임지지 않는다는
것을 잘 알고 있습니다.
Student Signature Date
Revised: 10/06/2014
International Student Sponsor Affidavit Form Please attach a current bank statement/letter in English and must be form a Checking/Savings/Certificate of Deposit account (no stocks or investments) with available balance of at least $20,000.00 USD. Name on bank statement must match sponsor’s information below.
PERSONAL DATA(TO BE COMPLETED BY STUDENT)
Student’s Name: Last Name(Family) First
Address:
Relationship to Sponsor: Name of Sponsor:
SPONSOR’S INFORMATION(TO BE COMPLETED BY THE SPONSOR)
Sponsor’s Name: Last Name(Family) First
Address:
Telephone Number: Email:
I, certify that this affidavit is made by me for the purpose of assuring Kernel University that I will take financial responsibility, including but not limited to educational and living expenses of the above mentioned student throughout the duration of his/her studies. I have enclosed the required bank letter or statement indication my ability to meet the expenses accrues by the above statement.
SPONSOR’S SIGNATURE
I certify that all information on this form is truthful to the best of my knowledge and I further understand that it is a
violation of the United States law to five false information to the University.
Signature Date
Revised 05/20/2015
F-1 Visa International Student Admission Agreement
Kernel University F-1 Visa students must comply with U.S. immigration regulations, institutional college and Kernel
University international student policies. Your signature validates your understanding and agreement to obey all
policies. To complete your admission process you must sign and return this agreement with your admission
documents.
I, to complete my admission to Kernel University to the following: Last Name, First Name
1. I understand that submitted transcripts and international student documentation become property of Kernel
University and will not be returned to me.
2. I understand that I must be enrolled in 12 units of college courses by the first day of the semester (Fall &
Spring). If I begin my studies in the summer, I am required to be enrolled in 6 units of university courses by
the first day of the summer or winter term.
3. If I drop below 12 units during any academic semester, without permission, I will be out of status with
Immigration and Customs Enforcement (ICE) and will be reported as such to federal authorities. My I-20 will
be terminated and I will be required to return to my home country.
4. I will notify the school staff anytime that I change my address, phone number, major or change schools. Such
changes must be reported within 10 days. Failure on my part to report any changes may be a cause to
terminate my I-20.
5. Make an appointment to see an International Student Advisor to have your I-20 signed for travel endorsement
(signature on 3rd page of I-20).
6. If I fail to meet the weekly study requirement (i.e. do not complete 18 or 22 hours of study per week) and/or
you drop below the 80% attendance minimum for an extended period of time, you will fall out of F-1 status.
This means you will be dismissed from Kernel University without a refund and your I-20 will be terminated. In
these cases, you must leave the U.S. immediately.
7. I know that I am not permitted to work (on-campus) unless authorized by a designated school official(DSO)
from the International Student Advisor. I know that I am not permitted to work outside of the school.
By signing this agreement, I acknowledge that I have read, understand and agree to all of the requirements listed
above. I understand that if I will not be admitted to if I do not agree to comply with all items noted.
Student Signature Date
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