The American Semester Program at
Michigan State University
Short Course Application 2016
Thank you for applying to the American Semester Program! All fields are required unless
otherwise noted. Visit http://americansemester.isp.msu.edu/ for more information.
Email questions and complete applications to american@msu.edu.
Select the Short Course you wish to apply for in the drop down list below:
*Names must match passport exactly
Personal Information
Family Name (Surname)
First Name
Middle Name
Date of Birth (mm/dd/year)
City of Birth
Country of Birth
Country of Citizenship
Country of Legal Permanent Residence
Permanent Mailing Address
Line 1
Line 2
City, Postal Code
Email Address
Cell Phone (include country code)
Emergency Contact Information
Name of Primary Contact
Relationship with Primary Contact
Phone Number (include country code)
Email Address
University Information
Home Institution
Major (course of study)
Minor
Date Started (mm/year)
Date of expected Graduation (mm/year)
Number of Semesters Completed
*By providing this information MSU has your permission to
contact this person in case of emergency
The American Semester Program at
Michigan State University
Short Course Application 2016
Michigan State University seeks to admit students who provide evidence of intellectual
performance, good character, and potential, which will permit them to profit from programs
of the academic rigor of those, offered by Michigan State. The University recognizes that a
secure environment enhances learning opportunities. As part of the admissions process, we
require applicants to respond to the following questions. Information provided in response
to these Questions needs to be reviewed, but rarely results in denial of admission.
1. Have you ever been expelled, suspended, disciplined, or placed on probation by any
secondary school or college you have attend because of academic dishonesty,
financial impropriety, or an offense that harmed or had the potential to harm others?
Yes
No
2. Have you ever been convicted of a criminal offense (including guilty or no contest
please and juvenile court proceedings) other than minor traffic violations or are their
criminal charges pending against you at this time?
Yes
No
If you answer yes to either of these questions, please explain in an attached letter. If
circumstances arise in the future (until the time you begin the program) that make your
answers to the above questions inaccurate, misleading, or incomplete, you must provide
the admission team at the American Semester Program with updated information.
Confirmation
Print Name
Signature
Today’s Date
*By signing you are verifying that all information is true to the best of your knowledge
The American Semester Program at
Michigan State University
Short Course Application 2016
Residence Hall Application
All students will be placed in single rooms with shared bathrooms in Owen Hall. Visit this
page for more information about this residence hall:
http://liveon.msu.edu/rivertrail/owen
Personal Information
Family Name (Surname)
First Name
Middle Name
Male
Female
Date of Birth (mm/dd/year)
Street name and number
City
Postal Code
Country
Email Address
Housing Options
Alcohol Free Setting?
Yes
No
N/A
Do you have health or
handicap related needs? (If
yes, elaborate in an attached letter)
Other (please fill in)
Other Information
Unisex T-Shirt Size
Cap Size (i.e. hat size)
I understand that this housing contract will be in effect for the duration of my program:
July 3-23, 2016 or July 10 - August 6, 2016.
Confirmation
Print Name
Signature
Today’s Date
The American Semester Program at
Michigan State University
Short Course Application 2016
Attach a copy of your Academic Transcript and any necessary letters to the end of the
application, or use the space provided below.