Please fill out the following form (Steps 1-4) in order to apply for admission to the American Language and Culture Program. Use SUBMIT to send your completed form to us.

STEP 1: Who You Are...
Mr. (male) Ms. (female)
Date of Birth:
Full Name:
[Last (Family) Name, First (Given) Name]
Address Line 1:
Address Line 2:
(if necessary)
City/State or Province:
Country:
Mail Code:
E-mail Address:

Home Phone:

FAX:

(include Country/City Code)

STEP 2: What Type of Program You Want...
Country of Citizenship:
Native Language:
VISA Status:
(Check one)
Requesting an I-20 to enter the U.S. on an F-1 Student Visa
Transferring an I-20 from another school in the U.S.
I-20 Not Necessary (e.g. resident alien, U.S. Citizen, etc.)
Conditional Admittance:

Conditional Admission Requirements

Graduate -
Undergraduate

Major:

(CSUDH requires a minimum 550 TOEFL score. A seperate $55 University application fee required to process application.)

Housing Preference: Apartment on Campus Homestay
No Housing Assistance Needed

(Students need to apply for housing well in advance of arrival. Failure to do so may force students to be wait listed.)

Where did you hear about California State University Dominguez Hills?
Friend/Family
ALCP Student Language Guide ALCP Website Language Website Agency Internet Search Engine

Other

STEP 3: When You Want to Start the Program...
Select one session from the list of sessions below:

2015 Intensive English Language Program Schedule

Term Testing & Orientation Class Dates Tuition
Spring A January 5 & 6
January 7 - February 27 $2,400 per session
Spring B March 2 & 3
March 4 - April 24 $2,400 per session
Summer A May 4 & 5
May 6 -June 26 $2,400 per session
Summer B June 29 & 30
July 12 - August 21 $2,400 per session
Fall A August 24 & 25
August 26 - October 9 $2,400 per session
Fall B October 19 & 20
October 21 - December 11 $2,400 per session

Please also send me information on Short-Term Programs (STP):
(Available Year Round by request)
STEP 4: How to Complete Your Application...
The following materials are also required for application:
  • This Application Form (or mail the printed version of this application form)
  • Insurance Requirment Goverment regulations require foreign students to obtain insurance to be on the campus. This insurance needs to be obtained from the ALCP program during the application process or when you come on campus.
  • Application Fee: $100.00 U.S. (check or money order payable to CSUDH; non-refundable; no credit cards accepted)
  • Financial Verification*: scholarship or bank statement verifying a minimum of $8,500 U.S. dollars for studies (* For those applicants wishing to receive I-20's to obtain F-1 Student Visas for full time study only)
  • Recommended - Express Mail ($100): Due to the variance between the mail systems of each country, delivery of I-20's by ground mail can be problematic. I-20's not shipped by express mail may not be re-issued if lost or stolen.


  • Return to the ALCP Home Page...
  • Go to the program application...


  • About the Campus...
  • About the Program...
  • Majors, Options, Concentrations
  • International Programs & Services
  • Program Application
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