~Application For English Language Program ~

Important! To apply, please send us the following items:

1. A Completed Application Form. It can be submitted by mail or on-line.

2. A Financial Certification in English showing that sufficient funds will be available to meet both your living expenses and tuition.

3. $100 Non-refundable application fee, $150 reservation fee (counts towards tuition), and $65 International Express Delivery Fee (if applicable)
   
   Payment can be made wire (please e-mail us for account information) or by money order / bank draft in U.S. Dollars, payable to:
   
   APEX Education Consultants
   1224 Notting Hill Dr.
   San Jose, CA 95131
   USA
   
   As soon as we receive this application and your payment, we will send you a packet along with your acceptance letter. You will receive information regarding the school, life in the U.S., I-20, airport transfer, and health insurance.

PERSONAL
    1. Last Name (Family):     First Name:
    2. Date of Birth:        3.  Gender:  Male. Female.
    4. Country of Citizenship:

CONTACT INFORMATION
    5. Address: 
              City:            Country: 
    6. Telephone:         7.  Fax:  
    8. E-mail:      

IMMIGRATION INFORMATION:
    9. Do you need an I-20 form to apply for an F-1 student visa ?     yes     no
        If you are already a student in the U.S., please give the name of the institution which issued your
        current  I-20:

LOCATION
    10. Please list  location and school that you want to study at. ( from our Locations page)
            Location:
            School:     
            When would you like to start the program?
            For how long do you want to attend the program?    

EXPRESS MAIL (check one)
     11.      Yes, I would like APEX to send my acceptance material by express mail service.
                      (I have included $65.00 express mail charges.)
                No, please send my acceptance material by airmail.

EDUCATION
     12.  How long have you studied English?
            What is your English ability? Beginner Low Medium High
            If you plan to attend a college or university in the U.S., please supply this information:
             Undergraduate  Graduate. Intended Major:

HOUSING
     13. Housing preference:    Host family. Residence hotel. School dormitory.
                                             Single room.Double room.     No preference.
          If you are interested in living with an American family, please fill out the following information:
          Do you have any special health conditions?
          Do you have any dietary requirements?        
          Do you smoke?            yes     no.
          Do you like pets?        yes     no   no preference.
          Are you comfortable to stay with a family with children?               yes    no.
          Do you have any interests and hobbies?      

  TRANSPORTATION      
      14. Do you need an airport transfer service? yes          no

  EMERGENCY CONTACT

   14. Name:        Relationship:
           Address: 
           Phone:           Fax:    
           E-mail:   

I understand that my application will not be processed until APEX receives the application fee and the Space Reservation deposit of $150 (where applicable). The Space Reservation Deposit is required to guarantee space. At registration, it will be credited towards your tuition. It will be refunded only if APEX receives a written cancellation notice and return of all acceptance materials one month before the term begins.

Please check this box to indicate signed approval: Date:

Your signature is required: "I have read and understood the conditions of this application. All of the information which I have given is true, to the best of my knowledge." signature of applicant

For more details please contact:

APEX School Search USA
Education Consultants
E-Mail: info
USA Fax: (240) 214-5648




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All rights reserved ®  Apex Education Consultants
November 1999