Summer Sessions Application

Program Year you will attend:*

Program Track:*

Personal Information

Name:*

First Last

Preferred Email:*

Phone:*

please include country code*

Gender:*

Date of Birth:*

Month

Day

Year

(MM/DD/YYYY)

Country of Citizenship:*

Address Information

Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Institution Information

* the university you currently attend

Name of Home Institution:*

Major:*

* area of study

Grade Level:*

Emergency Contact Information

Emergency Contact Name:*

First Last

Emergency Contact Relation:*

Emergency Contact Phone:*

please include country code*

Program Information

Please self-assess your English proficiency, focusing on your listening and speaking skills:*

High
Medium
Low

Special Dietary Needs / Accommodations:

T-Shirt Size:*

Please indicate your preferred messaging app:*

WeChat
Whatsapp
GroupMe

User Name (ID):*

Phone Number for Whatsapp account:*

Phone Number for GroupMe account:*

How did you hear about the program?*

Please specify if OTHER is selected:

Are you interested in being paired with a GSU student for language practice, cultural exploration, and friendship?*

Yes
No

What type of relationship do you hope to develop with your buddy?*

A casual friendship
A long-lasting friendship

Choose three (3) words that describe your personality:*

If not mentioned, list three (3) here:

How do you like to relax? (check all that apply)

Other:

Florida Trip Information

As a part of the Summer Sessions Program, there will be a 3-day weekend trip to Pensacola, Florida. Students will be staying at a hotel in double occupancy rooms (4 people per room) with the option to request a single room at an additional cost. *Please select an option below for your room preference.

Hotel Room Preference:*

I will stay in a shared room (included in program fees)
I would like to request a single room (at an extra cost of $440)

Note: Applicants must be 18 years old by 22 July 202