International Exchange Student Application for Admission

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International Exchange Student Application for Admission CURRENT PHOTO (optional) Submission Deadline: March 1 for Fall Semester, October 1 for Spring Semester Campus Box 49 Milledgeville GA 31061-0490 U.S.A. (478) 445-4789 Fax (478) 445-2623 Email: intladm@gcsu.edu http://www.gcsu.edu PLEASE TYPE OR PRINT NEATLY AND COMPLETE ALL SECTIONS. Name as listed on your passport: Family / Last Given / First Middle Country of Citizenship: Country of Permanent Residence: of Birth: Sex: Male Female Month / Day / Year Place of Birth: City / Country Current Mailing Address (valid until / / ): Month / Day / Year Street name and number Town or City Province Postal Code Country Telephone (country code + city code + number): Fax Number: E-Mail Address: Parent(s), Guardian, or Spouse's Name (circle one): Permanent Home Country Address: Street name and number Town or City Province Postal Code Country For visa purposes: Do you plan to bring a spouse or child with you to Milledgeville? Yes No If yes, please list name(s), relationship to you, country of birth, country of citizenship, and date of birth: Check Each Semester You Plan to Attend as an Exchange Student at Georgia College: Fall Semester (August December) Year Spring Semester (January - May) Year Home Institution: Major or Program of Study at Home Institution: Current Level: List any courses not included on your school transcript that are currently in progress at your home institution: Please study the Georgia College catalog to learn about programs of study and courses offered and complete the Proposed Program of Courses Form after consultation with your home institution exchange coordinator on course selection: http://www.gcsu.edu/registrar/catalog.htm and https://b7c.gcsu.edu:7297/pls/prod/gcsu_open_classes.pick_term_pub. Indicate the academic level that you are requesting: Undergraduate: studying full-time for enrichment purposes only. Graduate: studying full-time for enrichment purposes only. Major Subject of Study during Exchange Program at Georgia College: I certify that the information given above and on all other submissions with my Application for Admission as exchange student is complete and true. If my application is accepted and I become an exchange student, I agree to abide by the published regulations of Georgia College and the policies of the Board of Regents of the University System of Georgia. Signature of Applicant

To be completed by the Exchange Program Applicant I, (Print name of student) give permission for the Georgia College Registrar s Office to release my transcripts of courses taken in relation to the exchange agreement to the International Education Center of Georgia College for transmittal to the institution named below. I understand that I must arrange the awarding of credits for my Georgia College course work directly with my home university. I am a student pursuing courses for enrichment purposes only at Georgia College. I am presently not pursuing a degree from Georgia College. However, if I choose to pursue a degree at Georgia College any time in the future, I understand that I will need to apply and meet all regular admission requirements and be obligated to fulfill all requirements of that degree program. Signature of student To be completed by the Exchange Program Coordinator is authorized to attend Georgia College as an exchange student from Print Name of Student Name of student's Home / Exchange Institution Print name of Home Institution Exchange Coordinator Who Authorizes Exchange Title Signature of Exchange Coordinator at Home Institution Signature of Assistant Vice President for International Education, Georgia College Application Checklist All documents listed below should be given to the exchange program coordinator at your home institution at least three to four months prior to when you plan to enter the U. S. as an exchange student or by the deadline established by your home institution, whichever is earlier. Application for Admission Photocopy of Passport (if available at time of application) Letter from the Home Institution Exchange Program Coordinator certifying applicant's proficiency in English or TOEFL scores sent directly from the testing agency to Georgia College (institution code #5252) 1 Proposed Program of Courses Form Official (certified or attested) records of work completed at the home institution. An official English translation should be attached to all records not in English. This is extremely helpful for advisors to know whether students have necessary prerequisites for courses they want to take. Properly completed and signed Declaration of Finances Form assuring financial support indicating availability and supporting document 1 If you do not submit TOEFL or other approved standardized test scores, your English will be evaluated upon arrival in Georgia, and you may be required to take ESLG 1001: Introduction to American Language and Culture.

International Exchange Students Proposed Program of Courses Students should check the University catalog for programs of study and courses. The catalog is available on line at http://www.gcsu.edu/catalog and the schedule of courses for the semester by going to PAWS and then Class Schedule from http://paws.gcsu.edu/. The course selections listed below must be developed by the applicant in consultation with the Exchange Program Coordinator at the home institution. Study in the proposed courses is subject to availability of the specific courses at Georgia College for any given semester. Please note that not all courses are taught each semester and some may have restrictions on enrollment (required prerequisites must have been met or are available only to degree-seeking candidates). You will not be enrolled in a degree program at GC, but for enrichment only. You must arrange the awarding of credits for your GC course work directly with your home university. A transcript of your courses and grades will be sent to your home university at the end of each semester of enrollment. Undergraduate students normally register for 15 credits (or five courses) and graduate students normally register for 9 credits (or three courses) per semester. The minimum requirement for undergraduate exchange students is 12 credits, and for graduates 9 credits. Please indicate GC course numbers and titles. Fall Semester Selected Courses: Fall Semester Alternate Choices: Course Number Title Course Number Title 1. 2. 3. 4. 5. Spring Semester Selected Courses: Spring Semester Alternate Choices: Course Number Title Course Number Title 1. 2. 3. 4. 5. We certify approval of course selection (and/or alternates) to be taken at Georgia College. Printed Name of Applicant Signature Printed Name of Home Institution Exchange Program Coordinator Signature

Georgia College International Exchange Student Expenses for 2012-2013 You are required to certify that you have sufficient funds available for your academic and living expenses. Estimated minimum funds needed for a nine-month academic year. Undergraduate - 15 Credit Hours per Semester Tuition and Fees $28,000 Not charged at Georgia College for Exchange Students Technology Fee 144 Books & Supplies 1,200 Room & Meals 9,000 Insurance 1,200 Other Expenses * 2,600 Total $42,144 Less Tuition Not Charged -28,000 Total annual expense undergraduates $14,144 Year-long Undergraduate Exchange Students need to document that they have financial resources totaling at least $14,144. One-semester Undergraduate Exchange Students need to document that they have financial resources totaling at least $7,072. Graduate - 9 Credit Hours per Semester Tuition and Fees $21,000 Not charged at Georgia College for Exchanges Technology Fee 144 Books & Supplies 1,200 Room & Meals 9,000 Insurance 1,400 Other Expenses * 2,600 Total $35,344 Less Tuition Not Charged -14,344 Total annual expense for graduates $14,344 Year-long Graduate Exchange Students need to document that they have financial resources totaling at least $14,344. One-semester Graduate Exchange Students need to document that they have financial resources totaling at least $7,172. * Personal expenses and local transportation. Note: All expenses listed above are estimates only and are subject to increases each academic year. Estimates listed above are for expenses for Fall and Spring semesters ONLY (a 9-month academic year). Additional expenses for spouse: $500 per month or $6,000 per 12-month year. Additional expenses for child: $500 per month or $3,600 per 12-month year.

Georgia College Declaration of Finances INSTRUCTIONS: Please complete and return this form to the International Education Center, Georgia College, Campus Box 49, Milledgeville, GA 31061 USA. Complete the amount and sources of all support below. Please print all entries and enter amounts in U.S. Dollars. You must show official certification of support either with a bank official s signature and stamp or a bank statement indicating a sufficient amount. In addition, you must have a parent s or sponsor s signature unless support is from your own personal savings. Use an additional sheet of paper for explanations if necessary. A copy of this completed form will be returned to you together with your Certificate of Eligibility (DS-2019), both of which you need to present to the U.S. Consulate to request a student visa. Name of Applicant: SOURCES OF FINANCIAL SUPPORT PERSONAL OR FAMILY SAVINGS AMOUNT OF SUPPORT Name of Bank PARENTS AND/OR SPONSORS Name(s) For resources other than savings, please explain source. YOUR GOVERNMENT Name of agency Attach a signed copy of your Letter of Award. OTHER (SPECIFY) Attach a signed affidavit from source. TOTAL U.S. $ OFFICIAL CERTIFICATION OF SOURCES OF FUNDS AND AMOUNTS BANK CERTIFICATION: This is to certify that I have read the information furnished by the applicant on this form, that it is true and accurate, and that the funds are available. Bank Official s Signature and Bank Stamp Bank Official s Name (Printed) Title Name and Address of Bank SPONSOR CERTIFICATION: This is to certify that I have read the information furnished by the applicant on this form, that it is true and accurate, and that the funds are available and will be provided as specified. Sponsor s or Parent s Signature Sponsor s or Parent s Name (Printed) Relationship of Sponsor to Applicant Address STUDENT CERTIFICATION: This is to certify that the information provided on this form is accurate and complete. I acknowledge that I have sufficient funds available to cover my educational and living expenses while at Georgia College. Signature of Student