| First Name: |
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| Middle Name: |
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| Last Name: |
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| Gender: |
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| Country of Origin: |
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| E-mail Address: |
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| E-mail Address (#2): |
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| SAL program are you planning to attend: |
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| Have you applied yet? |
Yes
No
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| What type of housing are you interested in? |
SJSU's Campus Village Apartments (Single Room)
SJSU's Campus Village Apartments (Double Room)
SJSU On-Campus Housing
SJSU's International House
Homestay
Off-Campus Apartments
Hotels and Motels
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| Day you will arrive: |
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| Approximate date you will move out: |
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| Will you require an airport pickup: |
Yes
No
If Yes, please make sure to complete the Airport Pickup
Request form. |
| Do you have any other housing questions?: |
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