2+2 Pathway Program Application form

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1 2+2 Pathway Program Application form Our address and contact details Kings Pathways USA Admissions Cosmo Lofts 1617 Cosmo Street Suite 406 Los Angeles California USA T F E usabookings@kingscolleges.com

2 2+2 Pathway Program Application Form Student details Family name: First/given names: Date of birth: m m / d d / y y Male Female Country of birth: Current citizenship: Own language: Home address: Country: Mailing address (if different from home address): Country: Telephone: Fax: Passport number: Mobile telephone: Passport expiry date: m m / y y Parent/guardian details Family name: First/given names: Relationship to student: Male Female Home address: Country: Home telephone: Mobile telephone: Business telephone: Fax: Personal and medical information Please provide details of any medical conditions which require notification to Kings Pathways/Marymount College and/or require any prescribed medication. 1 of 6

3 Personal and medical information continued If you are not a US citizen, or lawful permanent resident, and you already have a visa, please indicate the type. Do you have a criminal record? (except traffic violation). If yes, please provide details. Student Insurance See Terms & Conditions for details of insurance requirements. For students following a Kings Academic Preparation Program, the cost of Kings student insurance will be automatically added to your invoice, unless you provide proof of alternative cover once your application has been accepted. Full details will be provided as part of your offer documents. Once you commence the 2+2 Pathway Program, you will need to take out Marymount College student insurance, or provide proof of an alternative policy. Please tick here if you do not require Kings student insurance: Accommodation requirements Twin student residence on campus Do you smoke?* Yes / No Check in date: m m / d d / y y Check out date: m m / d d / y y Please note: The entire Marymount campus is no smoking Do you have any special requirements? (eg. allergies, special diet) Airport Transfer Please tick this box if you require an airport transfer we will contact you for further details. Course of study Academic Preparation Program June 2013 / September 2013 / January 2014 / April 2014 / June University Pathway Program September 2013 / January 2014 Please indicate your preferred subject stream, if known: Business / Science/Technology/Engineering / Psychology / Liberal Arts Current level of English Please indicate your current level of English. (Please include a transcript of your formal test results with your application). Date Name of Examination or Certificate Grade or score If you plan to take any of the the following tests, please indicate which: SAT ACT TOEFL IELTS 2 of 6

4 Previous education Please provide details of your current or most recent school or college. (Please include with your application certified copies of all academic transcripts or reports (translated into English) for all high schools or colleges you have attended). Name and address of school (including country) Type of institution From To GPA (if known): If not enrolled, what have you been doing since your last enrollment as a full-time student? Personal interests Please include details about relevant personal interests in the boxes below. Please use a separate sheet if necessary. Academic Interests Athletics 3 of 6

5 Extracurricular Activities Awards and Recognition Future educational plans Please say what you hope to do after the 2+2 University Pathway Program, indicating which universities and subjects interest you. (Use a separate sheet if necessary) Family Educational Rights and Privacy Act (FERPA) Waiver: Authorization for release of information For the purpose of allowing others to assist me with my education, Kings Pathways and Marymount College may release information in my student record as necessary to facilitate evaluation, transfer, credit or management of my application, enrollment and continued progress at Kings Pathways or Marymount College. This authorization specifically permits the sharing of information in both directions between Kings Pathways and Marymount College, and from those parties to any person named below directly responsible for my recruitment or continued participation in the Kings 2+2 program at Marymount College. I understand that I have the right to revoke this authorization at any time. Sponsor name Grant authorization Withdraw authorization My Agency (Representative Name) Grant authorization Withdraw authorization My Parent(s) or other relative Grant authorization Withdraw authorization Other: (Please print) Grant authorization Withdraw authorization 4 of 6

6 Kings/Marymount Pathways Terms & Conditions Kings Pathways reserves the right to change prices, to cancel or change course, to amend timetables at any time prior to the application and to make additions or amendments to these terms and conditions by giving one months written notice to all affected parties. 1. Application Application Fee: There is a non-refundable $135 application fee payable before the processing of your application. You or your agent must send your completed application form with relevant transcripts and any supplementary documentation to Kings Pathways USA Admissions. We will acknowledge your application within 24 hours (Monday to Friday) and, if accepted, send an offer of a place within 4 5 working days. 2. Offer of Place Our offer of a place will include a study plan based on your academic ability and English language level and will detail cost for tuition and your selected accommodation options for one academic year. Your place is subject to availability and is not held until we have received your payment to accept the place. 3. Acceptance of Application To accept your place you will need to make a deposit payment. Once this payment is received we will hold your place until the balance of fees becomes due. Your place may become at risk if we do not receive your first term s fees on time. Several factors influence the amount stipulated as a deposit, the timing and the specific rules and regulations to apply. These specific rules and details will be shared with you and as such, you shall be responsible accordingly. All deposits shall be applied to the first semester of the Pathway program. 4. Visa Documentation Once we have received your deposit, we will hold a place and send all relevant visa documentation including the I-20, provided that you have complied with all financial requirements. Please advise us as soon as your visa is granted. If your visa is refused the advance fee and deposit will be refunded to the fee-payer on production of the visa refusal letter. 5. Payment of Fees All fees are due one month prior to the start of your course. Your place may be at risk if we do not receive payment on time. Fees can be paid by check, credit card (for Kings Academic Preparation Program only), bank draft or telegraphic transfer. Bank charges for both sending and receiving banks are payable by the sender. Payment by credit card is subject to a surcharge of 2%, AMEX 3.5%. In the event of late payment a monthly interest charge of 2% will be applied. You will not be allowed to attend classes as long as fees are outstanding. You may be required to leave the course if you are not able to produce payment or proof of payment. 6. Cancellation If you cancel more than four weeks before the beginning for any reason other than visa refusal, your deposit will be refunded minus $1,000 plus any additional accommodation deposit. If you cancel less than four weeks before the beginning of your course (Academic Preparation and/or Pathway) a full term of Academic Preparation and Pathway tuition and accommodation fees will be retained and any remaining balance shall be refunded. Cancellations must be given in writing to Kings Pathways USA Admissions. We strongly recommend that you have an insurance policy in place, which covers cancellation fees. Details of the reasons for cancellation covered by our recommended insurance policy are available from Kings Pathways USA Admissions upon request. 7. Withdrawal Kings Academic Preparation program: If you wish to withdraw from the course once the program has started, you are responsible for giving a full term s notice (12 weeks) to the Kings Program Manager. This means that you will effectively be responsible for the next term s tuition fees. Any remaining balance of fees paid will be refunded. Kings/Marymount Pathway Program: If you wish to withdraw from the Pathway Program, you will adhere to the Marymount withdraw rules and regulations found in the Marymount student handbook found at the following link: 8. Refunds Kings Academic Preparation Program: 1. Bank Charges: all refunds are paid minus any bank charges 2. Visa Refusal: The deposit will be refunded to the fee payer on receipt of visa refusal letter. 3. Tuition Fees: Any fees paid in excess of one term refunded to the fee payer if notice to cancel has been given. This excludes the current term in the event of withdrawal after the start of the term. 4. Accommodation Fees: Any fees paid in excess of one semester refunded to the fee-payer if notice to cancel has been given. 5. Accommodation Deposits: Refunded after student s departure to the fee payer after deduction for any disbursements or damages. 6. Late Arrivals: No refunds are given for late arrivals 7. Exclusion: No refunds are given for students excluded from program for disciplinary reasons 8. Insurance: No refunds given Kings/Marymount Pathway: 9. Refunds for students who withdraw during the course of the academic term will be provided in accordance with the Marymount Catalogue Academic Decisions Kings Pathways and/or Marymount reserves the right to determine the best course of study for any student and to exclude from class any student who, for reasons of performance or ability, is not qualified to enter or remain in that class. 10. Discipline If your work, attendance, or conduct is unsatisfactory you will be subject to Kings and/or Marymount disciplinary procedures. These procedures may lead ultimately to suspension or expulsion. In the event of suspension or expulsion, fees are not refunded. Travel and other costs incurred as a result of suspension or expulsion must be met by the student or student s guardian Kings Academic Preparation Program: Students attending the Kings Academic Preparation program will be governed by and subject to Kings Colleges standards of academic 5 of 6

7 conduct. Students residing in accommodation provided by Marymount College are subject to and must adhere to Marymount College s Community Standards found at: Kings/Marymount Pathways: Students attending the Pathway program, will be governed and adhere to Marymount College standards of academic conduct and Marymount College s Community Standards. marymountpv.edu/anchor-handbook 11. Accommodation All Kings/Marymount Pathway students will be accommodated in Marymount College on-campus housing. Housing assignments will be based on arrival time, duration of program and student s age. All Kings/Marymount Pathway students are expected to abide by Marymount College housing policies found at: marymountpv.edu/res-life-policies-faq#coc 12. Insurance All Kings Pathway students must have appropriate accident and medical insurance during their time in the USA. Insurance to cover personal property, breakages, loss and damage is also strongly recommended. Kings Academic Preparation Students: Insurance is available through Kings Pathways for Academic Preparation Program students only. Unless an alternative US plan with suitable coverage is provided, students will be automatically invoiced for insurance throughout the full length of their program. Kings/Marymount Pathway: All Kings Pathways students are required to purchase a health insurance plan written specifically for them by Marymount College. This plan is designed to meet the health insurance needs of our students studying away from their home countries. Information about the plan is available in the Office of International Student Programs or at the following web page. Students may opt out of the College Insurance Plan if proof of an alternative US plan with suitable coverage is provided. 13. Publicity Materials Permission is given for the use of student results, student comments or opinions and images or video of students in Kings Pathways promotional materials by the student, their parents or guardians with acceptance of these terms and conditions. 14. Federal Holidays and College closure Kings Academic Preparation Students: Tuition is not given on federal holidays (2013: January 1, January 21, May 27, July 4, September 2, November 28; 2014: January 1, January 20, May 26, July 4, September 1, November 27). The College is closed between 23 December 2013 and 1 January 2014 inclusive. Kings/Marymount Pathway The typical academic term includes a number of holiday breaks. See Marymount Academic Calendar marymountpv.edu/academics/calendar for exact dates. No refund or compensation is given for lessons missed due to holidays or other official class cancellations. The College campus is closed between December 23 and January 2nd. 15. Liability Kings Pathways will not be liable under any circumstances for any failure to provide any services whatsoever if that failure is caused directly or indirectly by actions or circumstances beyond Kings control. Any damage caused by a student to college property, to the homestay property or to a residence, whether intentional or not, will be charged to the student or students responsible. Students in residential accommodation are jointly liable for shared facilities and Kings Pathways reserves the right to recover costs for damage and exceptional cleaning at any time. 16. Student Information At the time of application, students are requested to sign a release form authorizing the College to share information about the student with designated officials of the College, Kings, parents and/or representatives. It is part of the unique nature of the Pathway program that Kings provides constant feedback about academic performance and/or financial issues to individuals involved in the student s success. 17. Jurisdiction I n any dispute arising out of this contract, the parties expressly agree to submit to the jurisdiction of the courts of the USA having jurisdiction in the matter in question. 18. Medical Intervention It is understood that if your child/ward is under 18 your permission is given for first aid to be administered as well as any other appropriate non-prescription medication. In addition to that, we equally assume that in the event of an emergency you authorize us to administer or provide your child/ward with any medication as instructed by a health professional and/or specialist. Equally, any emergency, dental, medical or surgical treatment, including an aesthetic or blood transfusion, as considered necessary by the medical authorities present would also be authorized by you. If you feel contrary to this, please advise us in writing, so that we keep a copy of this in your child s file and we therefore act in accordance with your wishes. Students will be required to provide medical history documentation prior to arrival in the U.S. 19. Activities and Excursions If your child is under 18 your permission is understood to be given for them to participate in off-site social activities and excursions organized by Kings and other external providers. Please advise us in writing if your permission is not given, in order for us to act in accordance with your wishes. Signed declaration I certify that all information submitted by me in this application is my own work, and is complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of facts in my application justifies a denial or cancellation of admission. I hereby apply for the 2+2 University Pathway Program, and accept the Terms & Conditions outlined in this application pack. Signature of student: Signature of student s parent/guardian (for students under 18): Date: m m / d d / y y Kings Pathways and Marymount College do not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, sex, age, marital status, parental status, physical disability, learning disability, political affiliation, veteran status, or sexual orientation. 6 of 6

8 The Application Process 1. The agent or student submits a completed Kings Application Form, Application Fee payment, certified academic transcripts, graduation certificate, and proof of English language level to Kings Pathways USA Admissions. If the student has a certified score of at least TOEFL ibt 61: 2. The agent or student submits a letter of recommendation, personal statement, and additional documents along with this Application Form. 3. Kings Pathways USA Admissions sends confirmation of receipt and forwards application documents to Marymount College. 4. If the application is successful, a Letter of Admission (LOA) and a formal invoice will be issued by Marymount College and will be sent to the agent or student by Kings Pathways USA Admissions. 5. The agent or student accepts the offer and pays the deposit directly to Kings Pathways. 6. Kings Pathways USA Admissions requests proof of funds/ sponsorship information. 7. Once funds are either proven or paid, Marymount College issues an I-20 and sends directly to the agent or student. 8. Upon acceptance, students will be required to submit original copies of the above documents, including supplemental forms. If the application is successful and the student has a score of below TOEFL ibt 61: 2. Conditional Letter of Admission (CLA) is issued by Marymount College, with the condition that the student successfully completes the Academic Preparation Program (AcP) level three. 3. This CLA is forwarded to the agent by Kings Pathways USA Admissions, together with an estimate of total fees and an invoice for the pre-sessional Academic Preparation Program. 4. The agent or student accepts the offer and pays the Deposit directly to Kings Pathways. 5. Kings Pathways USA Admissions requests proof of funds/ sponsorship information. 6. On receipt of these documents and proof of funds, Kings Pathways issues the I-20 directly to the agent or student. 7. Once the student successfully completes the Academic Preparation Program (AcP) level three, Marymount College requests proof of funds in order to issue a new I Upon acceptance, students will be required to submit original copies of the above documents, including supplemental forms. Please note: All documents must be submitted in English. Required Documents for Application Unofficial documents accepted with Application. All documents must be submitted in English. Official documents required at/before Orientation Letter of Acceptance Conditional Letter of Acceptance English Language Requirement TOEFL ibt 61/IELTS 6.0 AcP 3 Minimum GPA Pathway Application required required Application Fee required required High School and College Transcripts required required Transcript Evaluation optional optional Graduation Certificate required required Personal Statement optional optional Recommendation Letter optional optional SAT optional optional Post-Acceptance documents Health and Immunization Form required required Housing Application required required Required for I-20 Issuance Deposit (varies by country of residence) required required Reservation Agreement required required Certificate of Finances required required Passport copy required required /13 Please send your completed application by post, fax or to: Kings Pathways USA Admissions Cosmo Lofts 1617 Cosmo Street Suite 406 Los Angeles California USA T F E usabookings@kingscolleges.com

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