CSU SLI - Application

SLI Language Program - Mandarin
Summer 2011 - Academic Year 2011-12 - Summer 2012

New applications will not be accepted after March 25, 2011

Application Guidelines

The following form must be completely filled-in and submitted prior to the application deadline (March 26, 2011). All applications for the Mandarin Chinese program must be completed by midnight on March 25, 2011. The SLI program will notify you when your application is received and if any information is missing.

Additionally all applicants should send the following to the appropriate address for the language program for which they are applying:

A $30 check payable to CSULB Foundation (Memo: SLI Program) for a non-refundable application fee,
Current academic transcript including language courses taken and overall GPA (3.0 or higher),
and one reference letter from a language teacher.

Create a password to allow saving and editing of your application. Your email address is your user name.
You can make changes and updates at any time before the submission deadline. Remember to click the save button at the bottom of this page to save your changes.

E-MAIL ADDRESS:
PASSWORD:
	password	re-enter password

Applicant Information

NAME:
Last	First	Middle
NAME IN CHINESE:

AGE:		DATE OF BIRTH:				SEX: male female
			day	month	year

PLACE OF BIRTH:
City	State	Country

COUNTRY OF CITIZENSHIP:

PASSPORT NUMBER:		EXPIRATION DATE:
	(must have at least 6 months before Summer Study Abroad)		day	month	year

CURRENT ADDRESS:

Number and Street			Apartment Number

City	State	Zip code

CURRENT PHONE:
DAY:	()	-		EVENING:	()	-

CURRENT ADDRESS VALID UNTIL:
	day	month	year

PERMANENT ADDRESS (if different from current):

Number and Street			Apartment Number

City	State	Zip code

PERMANENT PHONE:
DAY:	()	-		EVENING:	()	-

WORK ADDRESS:

Number and Street

Apartment Number

City

State

Zip code

() -
area code and phone	e-mail address

EMERGENCY CONTACT:

Name

Relationship

Number and Street

Apartment Number

City

State

Zip code

() -
area code and phone	e-mail address

Employment History

EMPLOYMENT HISTORY:

Position	Employer/Location	Main Responsibilities	Dates





List additional employment history:

Academic & Language Background

CURRENT ACADEMIC AFFILIATION (if none, leave blank):
MAJOR:
CURRENT ACADEMIC LEVEL:	First year undergraduate Sophomore Junior Senior	Graduate Student
	If you are a senior, in what month and year will you graduate?

EDUCATIONAL BACKGROUND: List all institutions attended and dates of attendance, most recent first; major field of study; and degrees received and expected, with dates. Continue on another sheet if necessary.

Institution & Location	Dates of Attendance	Field of Study	Degree & Date Received or Expected

CUMULATIVE GPA:

TARGET LANGUAGE BACKGROUND: List all target language courses taken (include both university and others) and work experiences related to the target language beginning with the most recent.

Course # & Title	Institution & Location	Dates of Attendance	Field of Study





List additional courses taken:

TOTAL YEARS STUDYING THE TARGET LANGUAGE:

PREVIOUS STUDY ABROAD: Please list any previous language study programs in which you participated.

Program	Location	Dates





List additional study abroad experience:

TOTAL TIME SPENT STUDYING ABROAD (in months):

PROFICIENCY TESTS: If you have taken a target language proficiency test, please provide as much of the following information as possible.

Year	Skill	Score	Administering Organization	Test Type




List additional language proficiency tests taken:

PROFICIENCY IN OTHER FOREIGN LANGUAGES: Please list the number of years and location(s) of your study of other foreign languages.

Language	Place of Study	Number of Years





List additional foreign language experience:

Professional & Personal References

REFERENCES: List here the names, addresses, and phone numbers of the three people who can serve as your references.

SIGNATURE: Enter your full name in the box below to certify that all of the information in this application is true and complete to the best of my knowledge.

Statement of Purpose

Write/type below a 250-300 word essay in English addressing the following points:

What do you expect to achieve by participating in the SLI Language Program? How will being fluent in this language help you in your future? How will knowing this language and culture enhance your career opportunity? How will you continue to develop your language skill after you complete this program?

Essay in Target Language

Write/type below a short essay in the selected target language describing one particular aspect of the language or culture that you find interesting or unique.

The Southern CSU Consortium SLI Language Program

OPTIONAL: These questions are designed to help us better publicize this program. Your answers will not be considered during the selection process.

How did you hear about the SLI Language program? Please check one or more of the following:
Your professor Your University Website The CSU Chancellor’s Office Website Colleague or peer Other:	Former SLI Participant(s) SLI Coordinator/Faculty/Staff Listserv (please specify which)

Have you previously applied to any SLI Programs? Yes No

If so, please indicate for which program you applied and whether or not you participated.

Program name:

Program period applied for:

Participated Did not participate

Comments/Suggestions on SLI Program dissemination and recruitment: