SECTION A: ABOUT YOU |
| * First Name : |
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| * Last Name : |
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| * Home Address : |
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| Home Postal code |
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| Home Telephone : |
-
-
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| * Birthday : |
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| * Gender : |
Male
Female |
Local Address in USA
(if available) : |
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| Local Telephone : |
-
-
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| * Nationality : |
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| * Email: |
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| Your Plan |
| * First day of class : |
/
/
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| Expected last day of class : |
/
/
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| * How long will you study at ELI? |
month, or
weeks |
* Do you need an I-20?
(If yes, please complete Section C)
(What is this?): |
Yes
No |
Choose your program type
(What is this?): |
Regular Intensive English Course
Intensive TOEFL Preparation Course
Regular Intensive English Course + Business English Course
Conversation Excursion Course
(Spring/Summer Only) |
| Do you need airport transfer? ($ 80) : |
Yes
No |
| * What is your English Language skill level? |
Good
Fair
Beginner |
* ENROLLMENT AGREEMENT (4 weeks - PDF)
Click
to read |
I have read and agreed to the enrollment
agreement |
SECTION B: HOUSING REQUEST |
| Do you need housing arrangements? |
Yes
No |
| Please choose what kind of housing you need: |
Homestay
Residence Hotel |
| When will you need housing? |
-
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| Homestay Preferences |
Are you allergic to any foods?
Yes
No
If yes,
what types?
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Are you allergic to any animals?
Yes
No |
Is a host family with children okay?
Yes
No |
Do you smoke cigarettes?
Smoke inside
Willing to smoke out side
Non smoker |
| Residence Hotel Preferences |
Do you want a private or shared room?
Private
Shared |
Do you want a private or shared bathroom?
Private
Shared |
SECTION C: FINANCIAL INFORMATION |
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Estimated amount of money available in my personal bank account: |
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OR I will be sponsored by my family. Estimated amount of money available in my sponsor’s bank account: |
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To submit your application, please enter the following characters to confirm your information:
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