CALIFORNIA STATE UNIVERSITY, STANISLAUS ENGLISH LANGUAGE PROGRAM (ELP) APPLICATION FORM Application Instructions 1. Applications must be completed in English. 2. Applications must be completed and signed by the applicant; fill in all appropriate fields. 3. Type your name on the application exactly as it appears on your passport. 4. When all appropriate fields have been completed, print the application and sign on the final page. 5. Submit the following documents: Unofficially English Proficiency Score Report $150 Application Fee A photocopy of your current passport and I-20, if applicable Bank statement (Certificate of Finance) in English with $20,000 USD minimum A copy of previous TOEFL or IELTS exam (TOEFL PBT 400 or above; TOEFL ibt 32 or above; IELTS 4.5 or above) 6. Submit application and supporting documents to us by: Email Mail intlstudent@csustan.edu CSU Stanislaus Office of International Education - SSB 145 One University Circle Turlock, CA 95382 USA Fax US: (209) 667-3791 Application Costs: $150 Application fee Airport Pick-Up (optional): $295 San Francisco, Sacramento, San Jose, or Oakland International Application Fee, Express Mailing fees must be paid PRIOR to receiving an admission packet Airport Pick-up payments must be paid before pick-up reservation will be made Students with special needs or requirements should make these known at the time of application for consideration and approval. Note: ELP admission and program is separate from University admission. Acceptance to ELP is not admission to the University. If you are interested in a degree program, you must also complete the CSU Stanislaus application on CSU Mentor at: https://secure.csumentor.edu/admissionapp/intl_apply.asp ONE UNIVERSITY CIRCLE TURLOCK, CALIFORNIA 95382 WWW.CSUSTAN.EDU PHONE (209) 667-3117 FAX (209) 667-3791 THE CALIFORNIA STATE UNIVERSITY Bakersfield Channel Islands Chico Dominguez Hills East Bay Fresno Fullerton Humboldt Long Beach Los Angeles Maritime Academy Monterey Bay Northridge Pomona Sacramento San Bernardino San Diego San Francisco San Jose San Luis Obispo San Marcos Sonoma Stanislaus
PERSONAL INFORMATION (Please print information exactly as it appears on passport) Name (Family/Surname) (First) (Middle / / Birthday (Month/Day/Year) Country of Birth Citizenship Male Female Permanent Home Address: E-mail Address Phone Number Number/Street/Building City Province Country Postal Code Mailing Address (if different from above): Number/Street/Building City Province Country Postal Code Please indicate the session for which you are applying: Fall 2016 - Spring 2017 Academic Year Fall 2016 $4,490* Spring 2017 $4,490* August 18 - December 20 January 19 - May 24 *Plus Book Expenses of Approximately $350 (All prices subject to change) Course fees are due at registration during new student orientation. Payments are made at the Extended Education Office in MSR Building, Rm 240 upon arrival. Methods of payment are: MasterCard, Visa, American Express and check from a US Bank What is your educational objective in the United States? English Language Study Undergraduate Study Graduate Study What is your highest degree completion? High School Bachelor's Master's
What are your housing plans? University Residence Hall Homestay Off Campus Apartment Living Other Are you a U.S. Citizen or Permanent Resident? Are you presently in the U.S.? Yes No Yes No Please check all that apply: I would like to receive an I-20. I will be funded by: Personal Funds My Parents/Family in my home country U.S. Sponsor Other Sponsor I will have a spouse and/or child(ren) accompanying me with an F-2 visa *Please attach copy of passport(s) for each member of your family traveling with you **Please complete the Certificate of Financial Responsibility and attach it to this application. Terms and Conditions Student Agreement: I have read and fully understand all of the terms and conditions listed. I understand as an F-1 student, I must obey all immigration policies governing international students. I understand as an F-1 student, I must purchase and maintain health insurance. I understand admission to the ELP is NOT admission to a degree program at CSU Stanislaus. I understand payment for ELP class fees are due in full at registration. I understand I must show proof of immunization. Without proof of immunization, I will be required to receive immunization upon arrival at CSU Stanislaus. I certify I understand that the TOEFL exams I will take during ELP are institutional only (the scores are only accepted for admission purposes at CSU Stanislaus). These scores cannot be used for admission to other colleges and universities. I certify all the information is true and correct to the best of my knowledge. Signature of Applicant Date **APPLICATION WILL BE ACTIVE FOR 1 YEAR. AFTER 1 YEAR, A NEW APPLICATION AND PAYMENT MUST BE SUBMITTED.
In the space below write a statement of at least 300 words describing reason(s) for pursuing the English Language Program. This should be your own work. Check your work carefully before submitting your final statement. Please feel free to include anything that you believe would support your candidacy. Make sure to clearly explain why you want to take part in this program and why you want to attend CSU Stanislaus. Your application WILL NOT be considered without a complete statement.