Application Form

Personal Information

  (Given Name)

if any

  (In the form mm/dd/yyyy)
NOTE: Applicant must be 17 years of age by program start date.

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Immigration Information

Total number: 

Contact Information

Please enter your permanent home country address

Agency/Advising Center Information (if applicable)

Yes No

Where would you like your I-20 sent? *

Emergency Contact Information

Who should we contact in case of an emergency or medical situation?
(Can be parents, or relatives/close friends in US)

Medical Information

Yes No

I understand I will be required to purchase health insurance through the college
(only exception is for students attending through state-sponsored programs such as SACM)

Educational History

Yes No


SCC code: 4739 or SFCC Code: 4752
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Financial Information

Your payment option is: Credit Card

CCS accepts payments by Visa or Mastercard. Download and print the Credit Card Authorization Form and
  • fax it to (509) 533-8683 or
  • email it to

Housing Information

Housing placements are made in the order completed applications and placement fees are received.   Preferences are met based on availability.

CCS has two housing choices for new applicants. What is your preference?
Homestay Program - Please complete the Homestay section
Apartment living

Home Stay Applicants complete this section

What type of family do you prefer?
This information will be provided to your prospective Homestay family.

Yes No

Yes No

Release of Information & Admission Policy *

New students who use CCS's I-20 to enter the United States must:
  1. Report in person to CCS's orientation session for new international students
  2. Enroll for and attend the first quarter at CCS
  3. Present originals of passport, visa, I-94 and CCS I-20**
  4. Carry health insurance while enrolled at CCS
**Students transferring form other U.S. schools must present their most recent I-20 instead of a CCS 1-20, as well as this Transfer In (Status Verification) form.

By checking the box below, I verify that, to the best of my knowledge, all of the statements on this form are true. I have read and agree to the published International Student Admission Policies.