Form 3 application : Texas State Intensive English : Texas State University

Application #3: No I-20

Use application #3 if you hold one of the visa categories listed below. If requesting I-20, use #1.

date of entry

date stay expires

Check the intensive English program (s) you plan to attend.

Full Program Dates

Spring 2008: January 17 - May 1
Summer 2008: May 29 - August 7
Fall 2008: August 25 - December 4
Spring 2009: January 22 - May 7
Summer 2009: June 4 - August 13
Fall 2009: August 24 - December 10

Half Program 1

Spring 2008: January 17 - March 6
Summer 2008: May 29 - July 3
Fall 2008: August 25 - October 8
Spring 2009: January 22 - March 12
Summer 2009: June 4 - July 7
Fall 2009: August 24 - October 14

Half Program 2

Spring 2008: March 17 - May 1
Summer 2008: July 7 - August 7
Fall 2008: October 10 - December 4
Spring 2009: March 23 - May 7
Summer 2009: July 9 - August 13
Fall 2009: October 16 - December 10

Personal information All information must be the same as the undergraduate or graduate application.

last name (family) *

first name *

gender *

male
female

Date of Birth (mm/dd/yyyy) *

Country of birth *

Citizenship *

Native Language(s)

Mailing Address *

Email Address *

Telephone Number *

Texas State ID # (if known)

emergency contact

person's name

relationship to student

Telephone Number

Email Address

Fax Number

Currently attending another school in the U.S.?

yes
no

TOEFL information

Have you taken the TOEFL test? *

yes
no

If yes, highest toal score result

listening

structure (PBT only)

reading

writing (CBT or iBT)

speaking (iBT only)

If yes, test date: (dd/mm/yyyy)

Housing & Meals

on-campus-Spring or Fall (choose one)

Arnold or Smith
San Saba
Blanco
San Marcos

off-campus

I will make my own housing arrangements

Health Insurance

choose one *

Texas State's health insurance provider
Other

Application Review. Application is processed when all documents are received.

Read and check boxes *

1) I have read and completed this form correctly and carefully.
2) I will mail or fax (512.245.3752) copies of my academic records.
3) I understand that I must have sufficient funds for all expenses during my stay in the U.S.
4) I will send the US $40 application fee. (If you wish to pay with by credit card, Contact TSIE).

5) *

Yes, I would like to live on-campus. Reserve a space. I will send the housing deposit of US$100.
No, I prefer to make my own housing plans.

By clicking this button, I confirm that the application information is correct.

Division of Academic Affairs

Texas State Intensive English

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Form 3 application

Application #3: No I-20