Community Engagement Program Application

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APPLICATION FORM FOR COMMUNITY ENGAGEMENT &
U.S. CULTURE IMMERSION PROGRAMS

Student Information

(Applicants must be at least 18 years of age)

Gender *
Student Contact Information

(Please provide your address in your home country)

Application Type and Dates
Please choose the dates and type of program you are applying for: Community Engagement: July 22 – August 9 (3 weeks) Cultural Immersion: January 14 - February 8 (4 weeks)  Cultural Immersion: March 18 - April 12 (4 weeks)  Cultural Immersion: May 20 - June 14 (4 weeks)  Cultural Immersion: August 19 - September 13 (4 weeks)  Cultural Immersion: October 14 - November 8 (4 weeks)
Visa Information
Which type of visa are you planning to use to participate in this program? B visitor’s visa (already have it) B visitor’s visa (need to apply for it) Visa Waiver      List of qualifying countries:  http://www.esta.us/visa_waiver_countries.html Other       Please indicate visa type:

English Level

You must have at least a 400 TOEIC, 4.0 IELTS, 30 iBT, B1, or equivalent. Not available for beginner level!

Questions or Comments
How Did You Hear About this Program?
How did you hear about us?

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