Super Intensive & Graduate Academic English Programs Application 2018

Transcription

1 PLEASE PRINT Super Intensive & Graduate Academic English Programs Application N. Broad Street, 229, Philadelphia, PA USA FAMILY NAME: MIDDLE NAME: FIRST NAME: PERSONAL INFORMATION Date of Birth (month/day/year): / / Gender: Male Female Country of Birth: City of Birth: Country of Citizenship: Native (First) Language: Session Program Dates *Early Bird Application Deadline Super Intensive English Program Graduate Academic English July 8 August 4, 2018 July 23 August 17, 2018 May 15, 2018 June 4, 2018 Final deadlines for students outside of the United States June 1, 2018 June 12, 2018 June 26, 2018 June 25, 2018 ***Payment in full due: July 9, 2018 Final deadline for students in the United States June 18, 2018 June 25, 2018 July 9, 2018 July 20, 2018 Cost USD$2,150 USD$2,150 *Early Bird Deadline: $50 application fee is waived. **USD$250 deposit is required. This is a nonrefundable enrollment deposit which will be applied toward program tuition and secures your place in the program. *** Payment is due in full by the dates above. Students who do not pay by this day may be dropped from the program. Super Intensive students ONLY: Are you interested in a room package? (Information will be sent to you.) Yes No CONTACT INFORMATION Are you currently in U.S? Yes No Home Country Address: Street Address 1: Street Address 2: U.S. Address (if applicable): Street Address 1: Street Address 2: City: State/Province: City: State: Country: Postal Code: Country: Postal Code: Phone Number: Address: ACADEMIC INFORMATION U.S. Phone Number: Alternative Address: Which address do you prefer for your I-20 and welcome package to be mailed? Home Address U.S Address Pick up from IELP office Other** ** If you choose other, please provide a specific mailing address including street address, city, state, country and postal code for your I-20 mailing

2 Name of High School: Year of Graduation (ex: 2014) Name of University or College: Year of Graduation (ex: 2017) or Expected Year of Graduation (ex: 2019) Super Intensive and Graduate Academic English Programs Application 2018 FINANCIAL SUPPORT Please ensure that your financial support documents show the minimum funds required for tuition and living expenses: $3,725 o I am providing a letter from my bank showing that I will pay for my own expenses. o I am enclosing a letter from my family s bank in my home country. My family will pay for my expenses. o I am enclosing a letter from my government or other organization showing how much money they will provide. VISA INFORMATION o I need a Form I-20 to apply for an F-1 student visa o I am currently studying in the U.S. on an F-1 visa and will transfer my Form I-20. Name of current Institution: o I am currently studying in the U.S. on an F-1 visa but will only study at Temple in the summer and will remain in status at my current institution o I have been admitted to another department at Temple University Temple ID number: (9 digit number start with 91) o I do not need an F-1 student visa because: o I am a U.S. citizen or permanent resident o I have another type of visa that allows me to study in the U.S. Type of visa: (Please send a copy) o Other: ADDITIONAL INFORMATION What is your reason for attending Temple s IELP? Please select the option that best reflects your plans. I want to get a Bachelor s degree in the U.S. I want to get a Doctoral degree (ex. PhD) in the U.S. I want to improve my English for professional reasons I want to get a Master s degree in the U.S. I want to learn about American culture I want to improve my English because it is fun! Other How did you hear about Temple s IELP? Temple s IELP website Education agent: In-Country Student Fair: Other website: Friend: Counselor/Advisor: Other: APPLICATION CHECKLIST o Completed application o USD$50 application fee (non-refundable) * o Original bank or financial statement o SEVIS Transfer Eligibility Form (transfer students only) o Photocopy of passport 1415 N. Broad Street, 229, Philadelphia, PA USA *The paper application fee must be in the form of a check or money order. Check or money order should be made payable to Temple University. If you want to use a credit card, you are required to go online and pay your application fee. Please contact us if you have any questions

3 Mail the above application documents to Temple University IELP 1801 N. Broad Street, Conwell 403 Philadelphia, PA 19122, U.S.A - 3 -

4 1415 N. Broad Street, 229. Philadelphia, PA USA Super Intensive English and Graduate Academic English Programs Application 2018 TERMS AND CONDITIONS I understand that any misrepresentation of facts on the application or withholding of information may cause refusal of admission. I understand that I have a continued responsibility to notify IELP promptly of any information or facts that would change, add to, or otherwise relate to this application or my admission status. I understand that the IELP has the right to rescind admission status. I understand that the IELP will charge me a $50.00 NON-REFUNDABLE application fee. If I am transferring my SEVIS record to the Temple University IELP from another school in the U.S., I am required to begin studying at the IELP in the first available session after the SEVIS transfer is complete. If I do not begin studying in the first available session at the Temple University IELP, my current SEVIS record will be terminated. Applicant s name Date (month/day/year) MEDIA RELEASE, PARTICIPATION WAIVER & CODE OF CONDUCT AGREEMENT MEDIA RELEASE: I give my consent to Temple University, its employees, and its agents (collectively Temple ), as well as Temple s licensees, to take and use visual/audio images of me. Visual/audio images include any type of recording whatsoever including but not limited to photographs, digital images, drawings, renderings, voices, sound or video recordings, audio clips or accompanying written descriptions. I agree that Temple owns the images and all rights related to them and may transfer those rights. The images may be used in any manner or media without notifying me in advance. Such potential uses include educational, promotional, advertising, and trade, through any medium or format, including, but not limited to, videotape, audiotape, film, photograph, television, radio, digital, internet, theater, or exhibition, and may appear on university-sponsored web sites, a Temple licensee s website and in publications, promotions, broadcasts, advertisements, posters and theater slides. I waive any right to inspect or approve the finished images or any printed or electronic matter that may be used with them, or to be compensated for them. I understand that I will receive no consideration, monetary or otherwise, regardless of whether or not the project, or any part thereof, is published or sold. I release Temple and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such recording or use. I hereby freely and voluntarily consent to and irrevocably license the use and publication of the images by Temple and Temple s licensees from this date forward. CODE OF CONDUCT AGREEMENT: Temple University holds its students and staff responsible for their actions. Please read our Code of Conduct at and sign below to show that you have read and understand its contents. PARTICIPATION WAIVER: In exchange for participation in this program, I agree to accept all risks and release Temple University and its employees from responsibility for bodily harm and property damage that may occur while participating in this program. Please sign below stating you understand this statement. Yes, I certify that I have read and understand the information in this form and that this information is true and correct. SIGNATURE - 4 -

5 Applicant s name No, I do not want to give my consent to use my images. Date (month/day/year) 1801 N. Broad Street, Conwell 403. Philadelphia, PA USA Super Intensive English and Graduate Academic English Programs Application 2018 ADDITIONAL INFORMATION ACCEPTANCE The Intensive English Language Program will send admissions decisions by . Your application should be processed in 3 business days ( business days in the USA are Monday, Tuesday, Wednesday, Thursday, and Friday only). If you do not hear back from us in 3 business days, please ielpapps@temple.edu. I-20 APPLICATION The I-20, certificate of eligibility needed to apply for your F-1 student visa, will be created once you have submitted ALL the required documents. Please note that the IELP may require original bank statements be mailed before an I-20 can be issued. We will send you an admissions packet containing the Form I-20, an acceptance letter, and information to help you plan for your stay at Temple University. ORIENTATION We will send complete orientation schedules to the you provide on your application. Orientation provides arrival services that include airport pick-ups, shopping trips, and social activities. During orientation, students will get to know classmates, meet IELP faculty and staff, tour Temple and the Philadelphia area, obtain a Temple I.D., set up a Temple , pay tuition, take a placement test, and select courses. Note: Orientation is Mandatory. HEALTH INSURANCE (Mandatory)* Major Medical Insurance is required for students in the IELP with Non-immigrant Student (F-1 and J-1) status. You must present proof of insurance, in English, before classes begin each academic term. Your insurer must complete and return the health insurance confirmation form. Major medical health insurance must provide coverage for a minimum of $50,000 for the entire duration you are in the United States. Traveler's insurance is not acceptable for this requirement. If you do not have major medical health insurance or do not have proof of current coverage, you may purchase major medical health insurance at a discounted rate through GeoBlue Worldwide Insurance. You will receive more information in your welcome package. For additional information please visit ielp.temple.edu or us at ielpapps@temple.edu