Master of Science in Information Systems (Intl)
Please Note: Do Not Use the Back/Forward buttons on your browser when navigating through the application. Instead use the navigation links at the bottom of each page.
For International students only. U.S. citizens applying for Undergraduate Admission, please use the Common Application.
Important: Please print, complete and return the following Affidavit of Support document to email@example.com.
To start your application, click on the Begin Application button on the bottom right.
NamePlease enter your name as it appears on your passport.
First Name / Given Name
Legal Last Name
Preferred First Name
Maiden Last Name
Current PhonePlease enter your best phone number for contact from La Roche University.
Current Phone Number
Telephone / Email
Mobile Phone Number
Email Address (Format: firstname.lastname@example.org)
Emergency Contact InformationPlease enter the best information for your emergency contact person. (optional)
Home (Permanent) AddressPlease enter your permanent address in your home country.
Address Line 1
Address Line 2
Address Line 3
US State/Canadian Provence
Home Phone Number
Current AddressPlease enter your current address if different from your home address above.All documents will be mailed to this address.
Citizenship and Visa Information
Birth Date (Format: mm/dd/yyyy)
Are you a U.S. citizen or permanent resident?
Agent/Partner Representative ID Number
Are you in the United States under refugee status?
Country of Birth
Country of Citizenship
Please indicate the number of dependents who will accompany you to the United States.
A dependent is a husband, wife or child that is already on or will need to apply for an F-2 visa. For each dependent listed, please send a copy of his/her passport photo page with the rest of your application materials. If you are bringing a spouse, please also send a copy of your marriage license. If you are bringing children, please also send a copy of the birth certificate for each child.
Is English your native language?
What is your religion?(optional response)
Race(You may check more than one.)
Social Security Number*Must be provided if you are a US citizen/permanent resident who is receiving/applying for any financial assistance.
Enrollment & Housing
Planned Enrollment Year
Planned Enrollment Term
*Students on an F-1 visa MUST attend full-time.
What type of housing do you need?
Have you applied to La Roche University before?
How did you hear about La Roche University?
High School Graduation Date
Colleges/Universities Previously Attended
State of College/University(Upon selecting a state, please wait for the College/University Name box to finish populating before trying to select a school name.)
Name and Location of School if not listed
In consideration of being accepted to La Roche University as an F-1 student, I hereby agree to the following:
1. I will register for, attend and complete a full-time program of study each semester. I will maintain a cumulative grade point average (GPA) of 2.0 or an alternate minimum GPA as specified by my sponsor if I am in an undergraduate program. Note: Full-time study is defined as a minimum of 12 credits for undergraduate and English as a Second Language (ESL) programs.
2. If I receive any merit-based awards or scholarships, I will honor all conditions as a basis to keep the awards or scholarships
3. If required, I will take the English as a Second Language (ESL) placement test and classes upon arrival.
4. If required, I will take the Mathematics and College Writing placement tests, which will determine my readiness to enroll in College Algebra (the minimum core mathematics requirement) and College Writing 1 (the minimum core English requirement).
5. I will supply the university with final, official copies of all transcripts prior to registering for classes.
6. I will obtain the approval and signature of my academic adviser prior to scheduling, adding, dropping or withdrawing from classes.
7 I agree to purchase the mandatory medical insurance provided through La Roche University or provide proof of acceptable coverage prior to the start of classes.
8. I understand my financial commitment, and I am prepared to maintain myself financially for the period of time necessary to complete my education at La Roche University.
9. I will abide by the United States immigration regulations that relate to my visa status. Note: Please visit http://www.uscis.gov for more information on USCIS regulations.
10. I agree to keep my passport valid at all times.
11. I will report to the Office of International Student Services within 48 hours of my arrival in Pittsburgh.
12. I will obtain permission and a signature on my I-20 from the Office of International Student Services, should I decide to travel outside the United States for any reason throughout the duration of my studies at La Roche University.
13. I will provide a current address, telephone number, email address and emergency contact information to the Office of International Student Services upon arrival in Pittsburgh. I will report any change in my contact information to the Office of International Student Services within 10 days of its occurrence.
14. I will establish and regularly check my La Roche University email account.
15. I will abide by the standards outlined in the La Roche University Student Handbook.
I verify that I have read the above conditions and fully understand and agree with them.
Please indicate your acceptance of the International Student Agreement by selecting the option below.
In accordance with the Buckley Amendment and the Family Education Rights and Privacy Act (FERPA) of 1974, we will not release any information regarding admission status, academic records or financial aid to any persons other than the student applicant. If the applicant is or will be 18 years of age during the application process, the admissions staff must have permission from the applicant to discuss these issues with a parent, guardian, spouse or sponsoring organization.
Organizations providing scholarships or grants to cover the cost of post-secondary study typically require notification of admission status, regular academic progress reports and recurrent contact with a student’s academic adviser. In order for the faculty and staff of La Roche University to communicate with your sponsoring organization, you must select "Yes" and complete the information below.
I give permission for the release of my admissions, financial and academic records to the individual, sponsoring organization, and/or Agent/Partner Representative designated below.
Please provide the name, relationship, and contact information (i.e. Name, Address, email, and telephone number) for any individual or agency whom you authorize to discuss your information with La Roche University. Examples are your parents/guardians or your Agent/Partner Representative. Agents, please also include your 6-digit ID number in this box.
Intl High School Name