Refer to Admissions
Information for additional information on admission
requirements. We will contact you with information
specific to your individual needs.
To inquire on-line, please fill
in the following input fields on this form and then
click the submit button at the bottom of the page.
Thank you very much!
Note: Inputs fields with an asterisk (*)
are required.
#1 Enter all personal information as
accurately as possible.
*
Name
Title
Company
*
Street address
*
City
*
State/Province
*
Zip/Postal code
*
Country
*
Phone
Home Phone
FAX
*
E-mail
*
Date of birth
*
Sex
MaleFemale
#2 Inform us of your academic
background.
Number of years studying English :
If more than 3, specify:
Level of English proficiency:
Do you plan to study at an
American university or college?
Yes
No
Have you ever taken the
TOEFL? Yes
No
If yes, what was your score?
Date? (month)
(day)
(year)
Education (college or other
post/secondary):
How did you hear about English
Connection?:
#3 Issuance of I-20 Form (Student
Visa)
Students admitted to ENGLISH
CONNECTION receive a Certificate of Eligibility (Form
I-20) to obtain a student visa at the nearest U.S.
embassy or consulate. Students should check there for
any restrictions that apply. If a student's primary
purpose for entering the United States is to study
full-time it is important to obtain the F-1 student
visa.
Will you apply for a student visa?
YesNo
#4 Health Insurance
Do you have personal health
insurance? YesNo
Do you need health insurance from
ENGLISH CONNECTION? YesNo
#5 Course Sessions
ENGLISH CONNECTION offers rolling admissions
with sessions beginning every Monday for any duration
students desire. Our Intensive English Language &
Cultural Immersion Programs run Monday through Friday,
4 hours daily (20 hours of classroom instruction per
week). Super Intensive English Language Programs (30
hours per week) are also available. Private
instruction only, or private instruction in addition
to classroom instruction is also available. All
program fees are inclusive of tuition, accommodation
and meals where indicated.
Course Sessions
Select the desired type of session you desire.:
#6 Session Dates
Session Dates
Select the desired dates you would like to attend.
#7 Year to Attend
Year
Select the desired year you would like to attend.
#8 Select the type of accommodation
you desire.
Accommodations
Check the desired type of accommodation you desire.
Teacher w/meals
Host Family w/meals
Hotel (see notes)
Apartment (see notes)
Dormitory w/meals
Notes: Accommodation in hotel varies. Contact our
office for seasonal rates and preferences.
#9 Select Intensive or Super Intensive
Program.
Intensive or Super Intensive
Programs
Check the desired type of program you desire.
Intensive English Program
Super Intensive English Program
#10 Select yes for more information.
Professional & Corporate
Programs
Select yes if you would like more information regarding
our Professional & Corporate English Programs.
