Skip to main content

International Exchange Student Application

Student Information

Information must match your passport.

Gender *
Marital Status *

Contact Information

Home Institution Information

International Office Point of Contact

Academic Advisor's Information

Proposed Studies at Mississippi College

Anticipated Date of Entry
Program Length
Level of Study

Financial Information

Proof of Funding must accompany this form. All amounts must be in US Dollars. Please indicate both the name (source) and amount for each item in this section.

Medical Consent

In case of a serious illness or accident, I give Mississippi College or its representative (s) permission to secure medical and/or surgical care to include; transportation to a doctor or hospital of their choice, injections, examinations, medication and surgery that is considered necessary for my good health. I agree to pay all off campus medical costs. In the event of a condition requiring minor care, I approve of care under a physician. In addition, I understand that I must purchase health insurance in the U.S. through Mississippi College. Mississippi College has permission to communicate at any time with my parents and/or sponsor concerning my academic performance and issues related to my health.

Emergency Contact

Conviction Statement

Have you ever been arrested/convicted for anything other than a minor traffic violation? *

Student Agreement

I affirm that the information given in this application is accurate and complete to the best of my knowledge. Mississippi College is a Baptist institution and does not permit possession of or use of alcohol or drugs while enrolled. If admitted to Mississippi College, I agree to conduct myself in accordance with the high standards of Mississippi College and to abide by the policies and provisions stipulated in the College Bulletin, Student Handbook and/or other official College publications.