NEW New Student Application

New Student Application

Important Notice

All of the information in this online application is secure and confidential (Toda la informacion en esta solicitud de admision es segura y confidencial).

General Information

First name (Primer Nombre)

Middle Name (Segundo nombre)

Last name (Apellido)

Other Names Used, if applicable (Otros nombres usados, si aplica):

Street (Calle)

City (Cuidad)

State/Province (Estado/Provincia)

Zip/Postcode (Codigo Postal)

Country (Pais)

Email (Correo Electronico)

Cell Phone (Celular)

Would you like to receive text messages from JMVU? (By submitting the phone number and selecting yes here, you agree to the Privacy Policy and Terms of Service. By signing up for texts, you consent to receive marketing messages or any notifications from JMVU.)

Yes No Not Selected

Birth Date (fecha de nacimiento)

Place of Birth (Lugar de nacimiento):

Please enter city and country of Birth (Por favor incluya el pais y la cuidad donde nacio)

Nationality (Nacionalidad)

Gender (Sexo)

Ethnicity (Grupo Etnico)

Student ID photo (Foto de carnet estudiantil)

Start date (Fecha de inicio)

Program (Programa)

choose language of program (elegir el idioma del programa)

Do you plan to study online? (Usted tiene planes de estudiar en linea)

Yes No Not Selected

Copy of Government issue ID (Copia de la identificacion del gobierno)

Please scan or upload a color picture of your state license or passport (Por favor escanee o suba una a color de foto su licencia o pasaporte)

Social Security Number (Numero de Seguro Social)

This does not apply for students with or applying to an F-1 or M-1 student visa. Students with or applying to an F-1 or M-1 student visa please enter 000000000 (El numero de Seguro Social no es requerido para estudiantes que tienen o estan aplicando para una visa de estudiante F-1 o M-1. Estos estudiantes deben escribir 000000000 en el espacio)

Emergency Contact Information

Contact Name (Nombre de contacto)

Relationship (Relacion)

Cell Phone (Celular)

Work Phone (telefono del trabajo)

Home Phone (telefono de casa)

Employment Information

Employment Status

Job Title

Employer Name

Street Address

City

State

Country

Phone Number

Educational Information (Informacion de educacion)

What type of education did you obtain? (Que tipo de educacion obtuvo)

Please choose the type of education completed (Por favor escoja el tipo de educacion que completo)

Institution Name (Nombre de la Institucion)

Please write the full name of the institution (Institution is define high school, GED, college, university or any type of postsecondary institution) (Por favor escriba el nombre completo de la institucion) (Institucion se define como High school, GED, Universidad o cualquier tipo de institucion de educacion superior)

State or Country were education was completed? (Estado o Pais en donde completo su educacion)

COPY OF DIPLOMA (COPIA DEL DIPLOMA)

COPY OF TRANSCRIPTS (COPIA DE LAS NOTAS)

Only for graduate students (solo para estudiantes de postgrado)

Previous education information (Informacion de educacion previa)

Are you a first time college student? (Es primera vez que vienes a una institution educativa de educacion superior?)

Yes No Not Selected
This includes institutions attended outside the U.S.(Esto incluye instituciones universitarias fuera de Los Estados Unidos)

If no, please type the name of the institution (Si la respuesta es no, por favor escriba el nombre de la institucion)

If you don't have previous education please write N/A (Si no tienes educacion previa escribe N/A)

If no, please type the name of program completed at the prior institution (Si respondio no, por favor escriba el nombre del programa que completo en la institucion)

If you don't have previous education please write N/A (Si no tienes educacion previa escribe N/A)

Judicial Information

Have you ever had any professional license revoked, suspended, or had any disciplinary action taken against you by a professional regulating body?

Yes No Not Selected
This questions is only required for Master degree applicants.

Have you ever been charged with or subject to disciplinary action for scholastic or any type of misconduct at any educational institution?

Yes No Not Selected
If you answered yes to any of the above, you must submit a full statement of relevant facts on a separate sheet and attach it to this form. You may be required to furnish the University with copies of all official documents explaining the final disposition of related proceedings.

Have you ever been charged with a criminal violation before any forum?

Yes No Not Selected

Do you have any administrative or criminal actions pending before any forum?

Yes No Not Selected

Have you ever been convicted or found guilty, regardless of adjudication, of a crime in any jurisdiction, pleaded nolo contendere (no contest), to any charges in any jurisdiction or have you ever been a defendant in a military court-martial?

Yes No Not Selected

All Applicants

Date(fecha)

Student Signature (Firma)

I understand that this application is for admission to Jose Maria Vargas University. I also understand and agree that I will be bound by the regulations of the University concerning admissions requirements and all other University regulations. I further agree to the release of any transcript to this institution. I certify that the information given in this application is complete and accurate, and I understand that making false or fraudulent statements in this application may result in disciplinary action, denial of admission and invalidation of credits or degrees earned. Should any of the information I have given change, I shall immediately notify the Office of Admissions.