American Language Institute
Travel English for Active Adults 50+

2008 APPLICATION FORM

Rohnert Park, CA 94928-3609
Fax: 707 664-2749

Please fill out this form then print and include with other application materials as specified below:

With this signed application you must include:
Two SEPARATE checks or money orders payable to S.S.U.for U.S. $75.00 (non-refundable application fee)
        and $1,050.00 (non-refundable deposit) or provide credit card information on this application form
Copy of page one of your passport

PERSONAL INFORMATION

Name Female Male
                     last/family first

Date of birth Do you have a U.S. Social Security Number? No Yes
                            month/date/year

If yes, what is your Social Security Number?

Country of birth Country of citizenship

Will spouse or children come with you? No Yes

Home country address
                                                                 number & street city

    province/state country postal code

Home country telephone Fax

E-mail address

Current address and telephone (if different from above)

Please let us know your areas of interests/strengths so that we can provide you with information for your afternoon projects.

HOUSING INFORMATION

SSALI staff will be happy to arrange a homestay. Homestay placement fee is $40.
Other housing must be arranged by the student.

I will make my own arrangements.

Will you want SSALI staff to arrange a homestay? yes no
If yes, tell us about the following information.

Are there any special considerations we should be aware of when assigning your homestay?

TRAVEL INFORMATION

SSALI is located about 50 miles north of San Francisco. Transportation to Rohnert Park is either by bus
or private airport pick-up.

Do you plan to take the bus to Rohnert Park? (Cost: $28) No Yes

Will you want private airport pick-up from San Francisco International Airport? (Cost: $100) No Yes
(Note: the cost of $100 is paid directly to the person picking you up at the airport.)

FINANCIAL DECLARATION [Required for all F-1 Students]

If you want to pay your $75 application fee by credit card, please complete the following information:

Mastercard Visa

Card number Expiration date

Name on Card

MAIL YOUR APPLICATION MATERIALS TO:

Sonoma State American Language Institute
Attn: Barbara McCall
1801 East Cotati Ave.
Rohnert Park, CA 94928-3609 USA

KEEP THIS INFORMATION

FEES AND EXPENSES

Application Fee $75
Health Center Fee $143 (fall and spring only)
ID Card Fee $5
Medical Insurance $70/month

Homestay Placement Fee $40
Airport Pick-up Service $100 (payable to the driver)
Late Registration Fee $25

Other Expenses (variable):

Optional travel adventure $500~

FINANCIAL ADVICE

When you come to the SSALI office to register, pay tuition, and purchase insurance, payment can be made with
personal checks drawn on an American bank, money orders, or by credit card [VISA, MasterCard] We can accept
cash and travelers’ checks but prefer the other methods of payment.

MEDICAL INFORMATION

The SSU Health Center provides SSALI students with convenient on-campus care at a reasonable cost for minor medical problems.
You are advised to have full coverage health insurange to cover major medical expenses. When you register for classes, you will be expected to demonstrate that you have sufficient medical insurance.

HOUSING OPTIONS

AMERICAN HOMESTAY ($40 one time placement fee)

The student lives with a host family in the local community, generally within a four-mile radius of the University.

• Full Homestay $700 per month: 16 meals/week are included.

Note: SSALI Homestays are for SSALI students only.  When you complete your studies at SSALI, you are required to find alternative housing.

ON-CAMPUS HOUSING

On-campus apartments are available during the summer and occasionally at other times during the year.  Apartments are equipped with kitchens.  Students buy and cook their own ood.  In addition, students must supply their own utensils, plates, cups and silverware.  Sheets, blankets, pillows and towels are not provided.  Students interested in on-campus housing should contact the housing office directly at Housing Services, 1801 E. Cotati Ave., Rohnert Park, CA 94928 USA, Phone 707-664-2541, Fax 707-664-4158 or at http://www.sonoma.edu/housing/livingon.html.

@$675 (double) -- $825 (single) per month

TRANSPORTATION FROM SAN FRANCISCO INTERNATIONAL AIRPORT

Sonoma State American Language Institute
1801 East Cotati Ave.
Rohnert Park, CA 94928-3609 USA
ssali@sonoma.edu
Phone 707-664-2742
Fax: 707 664-2749
SSU American Language Institue web site