Academic and Professional Program Application


The English Center
7700 Edgewater Drive
Suite 540
Oakland, CA 94621
Phone (510) 836-6700
info@englishcenter.edu

On-line International Application for the English Center
The following information will be sent directly to the English Center when you press the “SUBMIT” button. You will still need to mail or fax your financial certification information. Your I-20 and acceptance letter will be sent to you only when we have received the financial certification and application fees.

Please be sure to check the certification box at the end of the application, just after the credit card payment. Checking this box is the same as our signature on a written application.

Your Name:
Last or Family Name*
First Name(s)*
Middle Name
Email*
Your Address:
Street or Post Office Box*
City*
Province/State
Postal Code
Country*
Your Telephone Number:*
Country Code
Number
Date of Birth*
Month Date Year
Gender* Male:              Female:
City of Birth*
Country
of Birth:*
Country
of Citizenship:*
Passport Number (if known)*
If married, will you bring your spouse? Yes:              No:
If yes, please give information about your spouse on the separate form for Dependent Information here.
Will you bring children? Yes:              No:
If yes, please give information about your spouse on the separate form for Dependent Information here.
How many children?
Address where acceptance should be mailed (if different from permanent address)
Street or Post Office Box
City
Province/State
Postal Code
Country
Mark the session in which you plan to begin your studies (refer to the Session Calendar & Fees)*
How many weeks do you plan to study at the English Center?
Are you currently attending a school in the United States? Yes:              No:
If yes, name the school: Please provide your SEVIS ID #: N
Do you plan to
apply for a student visa
(F-1)?*		 Yes:              No:
Do you need an I-20 form to apply for a student (F-1) Visa?* Yes:              No:
Education and English Language Level Name of Secondary school:
Secondary school location:
Name of College or University:
College or University Location:
Please rate your current ability in English:
None: Beginning: Low Intermediate:
High Intermediate: Advanced:
Further Study in the United States
If you are interested in applying to a college or university after completing your English studies, please complete this section. The information will help us to advise you after your arrival.		 Please check if you are interested in
undergraduate study graduate study

What field of study are you interested in?

List any colleges or universities you might apply to:
Housing Request Would you like the English Center to arrange a family homestay?
Yes:              No:
If yes, please include a US$250 placement fee with your payment of the application fee.

If no, please explain where you plan to live during your studies in the English Center:
Health Insurance Health insurance is required. Would you like to purchase the English Center Health Plan at the time of registration? (US$250,000 coverage for each injury or sickness; cost US$24/week)
Yes:              No:

If no, you must present evidence of your own coverage. It must provide a benefit of at least US$175,000 for each injury or sickness.
Where did you hear about the English Center?
Credit Card Payment:
(If paying by cashier’s check in US dollars, please mail it with your financial certification. If paying by wire transfer, please contact business@englishcenter.edu.)		 Visa MasterCard
Name of Cardholder:
Credit Card number:
3-digit security code (reverse of card):
Expiration date:
Month Year
Amount (check all that apply):
US$100 Application Fee
US$200 SEVIS Fee
US$250 Homestay Placement Fee

* I certify that all information provided on this form is correct and complete. I shall notify the English Center of any change in financial circumstances, or accompanying dependents, or plans not to attend the English Center. I will return the visa documents, if issued, if I postpone my admission to a later session or do not attend the English Center. (Checking this box serves the same certification purpose as signing and dating a printed version of this application form.)
Mail or fax your financial certification (bank statement or letter of sponsorship) to
The English Center, 66 Franklin Street, Suite 300, Oakland, CA 94607, USA
Fax: 510-836-6900
Your acceptance documents will not be sent until we have received the financial certification and application fee.
          
The English Center
7700 Edgewater Drive
Suite 540
Oakland, CA 94621
Phone (510) 836-6700
info@englishcenter.edu

Copyright © 2017 The English Center