ALCP Online Application - Summer Program: August 1 to August 23, 2008

You are applying to the CSUMB American Language and Culture Program

*Required information

I. Personal Information
First Name:*
Middle Name:
Last Name:*
Note: Input name exactly as it appears on your passport/documents)
Date of Birth:*	Birth Month Day Year
*Note:* ALCP students must be at least 18 when the session begins.
Gender:*
Country of Birth:*
Country Of Citizenship:*
U.S. Social Security No.:
If you do not have a Social Security Number, leave this blank.

II. Home Country Address Your place of residence in your home country (No P.O. Boxes - U.S. Immigration requires a physical address)
Street:*
Street 2:
City:*
State/Province:
Country:
Postal Code:
Telephone:
Fax:
Email Address:*
Cell Phone:
Emergency Contact Person:

III Mailing Address (if different from above)
Street:
Street 2:
City:
State/Province:
Country:
Postal Code:

IV. U.S. Contact (if any)
Name:
Street:
City:
State:
Postal Code:
Phone:
Fax:
Email Address:
Cell Phone:

V. Local U.S. Address Your Place of Residence Note: You must give your U.S. residence address to attend school if it is known. Click here to find out about the U.S. Immigration policy regarding students' U.S. addresses .
Street:
City:
State:
Postal Code:
Cell Phone:


VI. About your studies Tell us your purpose of studying English. How long do you plan to study in the United States?

Current School or University
Major or Intended Major
Current GPA (Grade Point Average)
Are you an F-1 student transferring from another school in the United States? Note: If yes, you must have your school fill out a transfer form and you MUST supply your LOCAL U.S. ADDRESS on this application as REQUIRED by the U.S. Immigration regulations.
If yes, which school?
The School Code
Do you have a SEVIS I-20?
If yes, what is your SEVIS ID number?

If you have already taken the TOEFL: (If you have not taken the TOEFL, you do not need to complete this section.)
Score:		Date Taken:
Non-academic interests (hobbies, sports, etc.)

VII. How did you hear about ALCP?

VIII. Comments/Questions: If you have any special needs or questions/comments about your application, please explain here:

IX. Payment Information What form of payment are you using?
(For credit card payments)
I hereby authorize CSUMB to charge $2,555 USD
Credit Card Number		Expiration Date
Cardholder Name (as printed on credit card)
Cardholder Signature (required) ___________________________
Daytime Phone
Message Phone

ALCP Online Application - Summer Program: August 1 to August 23, 2008

I. Personal Information

II. Home Country Address

III Mailing Address

IV. U.S. Contact (if any)

V. Local U.S. Address

VI. About your studies

VII. How did you hear about ALCP?

VIII. Comments/Questions:

IX. Payment Information

(For credit card payments)