Part I
Gender:
Male
Female
Family Name:
First Name:
Middle Name:
P ermanent Mailing Address (Home
Country)
Address:
City:
State/Province:
Country:
Phone:
Fax:
E-Mail:
U.S. Address
(if applicable)
Address:
City:
State:
Zip Code:
Phone:
Personal Information
Date of Birth (DD/MM/YYYY)
:
Country of Birth:
Country of Citizenship:
Language Spoken at Home:
Highest Degree:
Major Field of Study:
Do you
plan on studying at an American university of college after attending
ELI?
Yes No
How
did you first hear about ELI?
Referral by a student or former student
Received information by mail
Other personal referral
Telephone Directory
The Internet
Other
Major medical insurance and Measles and
Rubella immunization required at registration.
Are
you a permanent resident of the United States?
No
Yes
If yes, please
provide registration A#:
Are
you currently in the United States on aF-1 Visa?
No
Yes
If yes, what institution
issued your I-20?
Please note
that you will still need to apply for an I-20 from the English
Language Institute in order to transfer your student status.
If you are not on a F-1 visa, what type of visa do
you currently hold?
J-1
B-2
A-1
F-2
Other:
Part II
(All applicants who require an I-20 for a student visa
should complete this section):
In order to obtain an F-1 student visa to study at the English
Language Institute, you must submit financial certification.
Financial certification is the documentation which shows that you
have the minimum sum of US$9,000.00 available for each semester that
you intend to study at the ELI. (Additional funds required for
dependents). Please check all categories that apply to your
situation.
I am planning to support myself
through personal savings. I have attached a certified letter from my
bank which verifies that I have US$ in my personal savings account.
My parents and/or sponsors will
support me. I have attached a certified letter from the bank of my
parents and/or sponsors which verifies that US$ are available to me to study at
Florida International University. Also attached is a certified letter
which verifies their commitment.
My government is sponsoring
my studies. I have attached a certified letter from my government
which verifies that US$ are available to me.
My family will accompany me to
the United States.
For each family member,
spouse and/or child accompanying you to the United States, please
provide first and last name, date of birth, country of birth and their
relationship to you:
How will you support your
dependents if they join you in the United States?
IMPORTANT: I certify that the total amount of
money available to me for this academic year in the United States is
US$ .
Furthermore, by submitting this form, I certify that all information
provided by me on this form is complete and correct, to the best of my
knowledge.
I am applying for (please select one of the following)
:
The Intensive
English Program (IEP)
The Academic
English Program (AEP)
Fall term (October-December)
Fall term
(October-December)
Winter term (January-March)
Winter term
(January-March)
Spring term (April-June)
Spring term
(April-June)
Summer term (July-September)
Summer term (July-September)
Tuition and fees for IEP
include the cost of three of our four basic classes, laboratory, FIU
student activities fee, II) (includes library privileges,
extracurricular activities, and use of athletic facilities), health
services fee, orientation brunches, graduation lunches, and
traditional holiday festivities.
Practical Conversation Program (Full Term)
Practical Conversation Program (Half-Term)
Fall term (October-December)
Fall term
(Oct-Nov)
(Nov-Dec)
Winter term
(January-March)
Winter term (Jan-Feb)
(Feb-Mar)
Spring term
(April-June)
Spring term
(Apr-May)
(May-Jun)
Summer term
(July-September)
Summer term
(Jul-Aug)
(Aug-Sep)