2015-2016 Exchange Program Application
Please return this form to:
CLU Study Abroad Center
Email: studyabroad@callutheran.edu
Application Procedure and Information
Section A: Student Information
Male
1. Name: Female
Last / Family / Surname First / Given Middle
2. Address:
Number Street Address
City State/Province Postal Code Country
3. Phone Number: (Home) (Mobile)
4. E-mail:
5. Date of Birth: 6. Marital status: Not married Married
Month Day Year
7. Country of Birth: 8. Country(ies) of citizenship:
9. U.S. Social Security Number (If applicable):
10. Emergency Contact Information: Please give the name of a contact person in your home country in the event of an emergency:
Name: Address:
Email:
Phone:
Fax: Relation to you:
(Family member, friend, teacher)
Once approved to attend Cal Lutheran, you will receive
additional information about the following:
1. Student visa
2. On-campus housing
3. Health forms
4. Course registration
5. Student orientation
6. Arrival
Application Procedure:
Please complete and return this application and
supplemental materials (see Section D) to Cal
Lutheran’s Study Abroad Center.
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Updated March 2015
Section B: Program Information
11. When do you plan to attend CLU? Fall Spring Full Academic Year
Year Year
12. Current university or partner institution:
13. Exchange program administrator:
Name: Phone: Email:
14. Current year of university study: 1st 2nd 3rd 4th 5th
15. Academic program of study or degree program:
16. Proposed course selection at CLU:
17. First language: 18. TOEFL / IELTS Score (if applicable):
Section C: Financial Support Information
International exchange students do not pay tuition to Cal Lutheran but are responsible for all other expenses and fees. In order to obtain
a student visa, financial support must be shown for a minimum of 9,300 USD. This includes housing, board, international student fees,
and additional estimated costs for textbooks and other expenses.
Please submit the Certificate of Financial Support to fulfill conditions of the United States government in obtaining an F-1 visa to
study in the U.S. You are required to verify your financial resources in the form of a certified bank statement or letter of support.
Section D: Request for Supplemental Materials
19. Please submit the additional documents: (must be submitted with application)
Official transcript from current university
Copy of your passport’s identity page
Section E: Signature
I hereby certify that the information set forth in this application is true to the best of my knowledge. All documents and materials which
relate to my application become the property of California Lutheran University. I hereby agree to abide by all the rules and regulations
set forth by the University, particularly those articulated by the Study Abroad and International Student Programs Offices at Cal
Lutheran.
STUDENT’S SIGNATURE: DATE
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Updated March 2015