Ðồng Hồ Phiên applied for admission to Blue Ridge Community College for the summer 2017 term. He provided his personal information including name, date of birth, address in Houston, Virginia, and contact details. Ðồng Hồ Phiên is a male international student who graduated from a foreign high school in January 2015 and will pay out-of-state tuition rates.

1. Page 1 of 4
Blue Ridge Community College
Application For Admission
Prefix Doctor
First Name Đặng
Middle Name H#
Last Name Phi#n
Suffix Jr.
SSN 454640785
Former First Name
Former Middle Name
Former Last Name
Date of Birth 1/1/1996
College Blue Ridge Community College
Campus Main Campus
Class Type CRED
Term 2017 Summer between
05/22/2017 and 08/01/2017
Plan Career Exploration (023)
Previous Student or Employee N
Emplid 7112079
Primary Phone 832-828-1814

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Street Address 1 439
Street Address 2 Werninger
City Houston
State VA
Postal Code 77030
Country United States
Current Residence VIRGINIA BEACH
Have you lived in Virginia the past twelve
months?
Y
Email khanhtuanplus@gmail.com
Student's Employer (If Employed)
Business Phone 975-179-0501 Extension 1
Emergency Contact First Name HUỲNH
Emergency Contact Last Name TUẤN
Emergency Contact Relationship Child
Emergency Contact Phone 84975179050
Ethnicity
Gender Male
English is Primary Language Y
Military Status No Military Service
Citizenship Status Native

3. Page 3 of 4
Level of high school education Foreign High School (graduated
or currently enrolled)
Actual or Anticipated Graduation Date Jan 2015
Father's Highest Education Received Post-Bachelor's
Degre
Mother's Highest Education Received Post-Bachelor's
Degre
Are you a U.S. citizen? No
Are you a permanent resident of the U.S.? No

4. Page 4 of 4
Application Confirmation
Name Đặng H# Phi#n
Date Submitted 11/29/2016
Emplid 7112079
Username nhp2266
Tuition Information Based on the residency
information you supplied, you
will receive out-of-state tuition
rates.
Assigned Plan Career Exploration (023)
Administrative Contact Admissions Office
Phone 540-453-2287
Admissions Website http://www.brcc.edu/
admissions/
The signature of a parent or guardian is required for applicants under the age of
18.
Parent/guardian signature: ________________________________________