International Student Information Request Form

First Name *

Last Name *

Date of Birth (mm-dd-year) *

Address *

City *

State

Zip/Postal Code *

Country

Telephone Number *

Country code, area code, phone number

Email: *

Intended Start Date

Fall

Spring

Intended Major/Degree or Area of Interest:

If "Other", please specify

How did you hear about Penn State Scranton Programs?

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Application

Financial Aid

Admissions Information

Please type any additional information or questions in the box below: