English Language Program Application 2020

English Language Program Application 2020
Please check the session you want to begin: *

Fall 2020 (August 17-December 4) Spring 2021 (January 11-April 30) Fall 2021 (August-December)
What type of admission do you want? *

English classes only Conditional Admission to Georgia Southern University (After you complete the English Language Program, you want to study for a bachelor's degree. Conditional Admission is only for students who have never studied at a university. )
Please make sure your name is exactly the same as on your passport (you MUST provide a copy of your passport).
Full Name *

First/Given Name Middle Name(s) Surname/Family/Last Name
Birth Date *

Month Day Year
Gender *

Male Female
Country of Birth *
Country of Citizenship *
Visa

I am planning to apply for a student visa (F-1). I already have a student visa (F-1). (Transfer only) I am a United States resident/citizen. I have a B1/B2 visa. (part-time study only)
Address (in your home country) If your country doesn't have a postal/zip code, enter 0) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Country Code Area Code Phone Number
Your Email *
Please check your email address.
Person to contact in case of an emergency
Name *

First Name Last Name
Phone Number *

Country Code Area Code Phone Number
Relationship *

Agreement
**I understand that by signing this application that all the information provided is correct and true to the best of my knowledge. I understand that, without my signature and application payment, this application is considered incomplete and will not be considered for admission purposes.
Please pay the $50 non-refundable application fee now.
*

I agree
Applicant's Electronic Signature: *
First / Last name
Date

Month Day Year
Should be Empty:

Education