Online Application for Admission

Name *

First

Middle

Last

Date of Birth *

Phone Number *

Email Address *

Country of Birth *

Country of Citizenship *

Overseas Address *

Local U.S. Address

Emergency Contact Name *

First

Last

Relationship To You *

Emergency Contact Phone Number *

Emergency Contact Email *

Status You Will Be Attending As *

If Other Please Specify

Program *

Number of Weeks *

Select Year *

Select Month *

Courses *

Please check all that apply

Airport Pickup

Flight Information

If yes, please provide your flight details

Housing Placement

Duration of stay

Housing Checklist

I would like meals
I do not require meals
I am ok with pets
I am ok with children

Please check all that apply if you require housing placement

Required Documents

Photocopy of passport
Visa (if applicable)
Copy of High School diploma
Financial statement showing proof of ability to finance education and living expenses

Please ensure you have the following documents before applying. You will be required to provide copies of all of the following documents in order to determine your eligibility.

Credit Card Number

In order to process your Application for Admission you will need to pay your $150 non-refundable application fee.

Name On Card

Expiration Date

Security Code

Card Type

Authorization

Yes I understand

By clicking the box you understand and authorize that Rosemead College will charge you a $150 application fee with the credit card information you've provided.