affidavit of english as native language

AFFIDAVIT OF ENGLISH AS NATIVE LANGUAGE
The countries listed below have English as one of their Official Languages and as the Language of
Instruction in Higher Education, therefore students from any of these countries are considered English
proficient and are exempt from taking the TOEFL exam for admission to Polk State College.
Anguilla
Antigua and Barbuda
Australia
Bahamas
Barbados
Belize
Bermuda
Botswana
British Virgin Islands
Cameroon
Canada (EXCEPT Quebec)
Cayman Islands
Dominica
England
Fiji
Gambia
Ghana
Gibraltar
Grenada
Guyana
Ireland, Northern
Ireland, Republic of
Jamaica
Kenya
Lesotho
Liberia
Malawi
Malta
Mauritius
Montserrat
Namibia
New Zealand
Nigeria
Papua New Guinea
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Scotland
Seychelles
Sierra Leone
Singapore
Solomon Islands
South Africa
Swaziland
Tanzania
Tongo
Trinidad and Tobago
Turks and Caicos Islands
Uganda
United Kingdom
US Virgin Islands
Vanuatu
Wales
Complete the Affidavit below if you are a citizen of one of the countries listed above and if English is your native
language. If English is not your native language you will need to prove English proficiency in another manner. See the
International Student Admission Requirements in the college catalog for other means of proving English proficiency.
I, (print your name) ______________________________________________ certify that I am a citizen of
(country – must be on the list above) _______________________________________ and that English is
my native language and the primary language spoken in my home.
__________________________________________
Signature of Person Named Above
_____________________________
Date of Signature (mm/dd/yy)
Polk State College is committed to and encourages equal opportunity/equity/access for its programs, services, and activities.