~Application For Super Value Program ~

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

1. A Completed Application Form. It can be submitted by mail, fax 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. $250 Non-refundable Application, and $65 International Express Delivery Fee (if applying 4 weeks or less prior to start date)
   
   Payment can be made by wire (please e-mail us for account information), money order or 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 the 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.

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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:

PROGRAM
    10.  When would you like to start the program? Monday(mm/dd/yy)
            For how long?     months

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.

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EDUCATION
     12.  How long have you studied English?
            What is your English ability? Beginner Low Medium High
           
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 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 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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January 2000