International Student Services Admission Application

Please provide us with the following information so that we can begin processing your application.

Note: This application is for international students only.

International Student Application

Personal Information

As it appears on your passport.
As it appears on your passport.
Serious crimes include but are not limited to: burglary, theft, arson, aggravated assault, fraud, sexual assault, etc. Please do not check yes for lesser crimes such as traffic violations, littering, building code violations, etc. View all definitions

Personal Contact Information

Information about agent will be asked later

leave blank if none

Permanent Mailing Address

Local Address

Emergency Contact Information & Family Information

List Any Dependents

Admission Status

ESL = English as a Second Language

Educational Background

List high school(s) attended.

Post Secondary Education

List all colleges previously attended. Have an official copy of the transcript sent to the DSU Admissions office. Please include name of institution, location, graduation date, credit/degree.

Optional Information

What agency directed you to Dixie State University?
Agent's Mailing Address

Acceptance of Terms

By submitting this form, I certify that the above information provided in this application is true and correct to the best of my knowledge. I also declare that if I attend Dixie State University I will abide by the academic, scholastic, and social standards of the university. A student found guilty of nondisclosure or misrepresentation in filling out this application form will be subject to disciplinary action and dismissal from the university.