Cal Poly Humboldt Study California Application

(if applicable)
If you are working with an agency, please list the agency name.
Please list the name and location of secondary school attended.
Please list name and location of any colleges/universities attended.

Certification to be read and digitally signed by all applicants to certify the accuracy of the information provided:

I certify under penalty of perjury under the laws of the State of California that I have provided complete and accurate responses to all the items on this application. I further certify all unofficial documents submitted in support of this application are unaltered records that pertain to me. My signature certifies the accuracy and completeness of the information provided. I understand that any misrepresentation or omission may be cause for denial or cancellation of admission, transfer credit, or enrollment.

By checking this box, I understand that I will not be allowed to register for courses until all Cal Poly Humboldt degree seeking students have secured their class space. I understand that my registration is dependent upon the extra, available seats only. I understand that specific classes I desire or “need” cannot be guaranteed.

Make sure to submit:

Health insurance: You are required to have health insurance for the time you are enrolled at Cal Poly Humboldt. All international students are automatically enrolled in the CSU Healthlink program and must pay the fees each semester. You will be insured from August 10 for the fall semester and from January 10 for the spring semester.

You will need to bring with you:
  • Your latest transcript (to show completion of classes needed as prerequisites for classes you want to take at Cal Poly Humboldt).
  • Proof of measles immunization: You are required to have been immunized (vaccinated) against measles to study at Cal Poly Humboldt. You must show proof of two doses of vaccine after age one. If you have been immunized against measles in your home country (or elsewhere), please bring proof of immunization to Cal Poly Humboldt International Programs on the first day of orientation. If your immunization record is in a language other than English, it must be translated into English. You will be blocked from registering for classes until you have been cleared by the Cal Poly Humboldt Student Health Center. Though the Student Health Center can provide these vaccines, they must do so at cost (approximately US $45). As the Student Health Center does not bill insurance companies, it is best if you receive immunizations from your own doctor, where the insurance company can be billed and the fee may be lower.

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Files must be less than 50 MB.
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Files must be less than 50 MB.
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Please make sure your emergency contact is aware that they are your emergency contact.
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