UNIVERSITY OF PENNSYLVANIA ENGLISH LANGUAGE PROGRAMS Enrollment Form 2018-2019 PROGRAM INFORMATION BEGINS ON PAGE 4 PROGRAM SELECTION Please check the sessions you plan to attend. Programs with an asterisk (*) may only be taken for one session. Intensive Program University Connection or Institute for Academic Studies* Fall 1, 2018 Spring 1, 2019 Summer 1, 2019 Fall 1, 2019 Spring 1, 2020 Fall 2, 2018 Spring 2, 2019 Summer 2, 2019 Fall 2, 2019 Spring 2, 2020 Fall 1, 2018 Spring 1, 2019 Summer 1, 2019 Fall 1, 2019 Spring 1, 2020 Fall 2, 2018 Spring 2, 2019 Summer 2, 2019 Fall 2, 2019 Spring 2, 2020 January 2019 February 2019 July 2019 January 2020 February 2020 Global Citizen Study Abroad Program Full Program Fall 2018 - Spring 2019 Summer 2019 - Fall 2019 Fall 2020 - Spring 2021 Accelerated Program Fall 2018 Spring 2019 Fall 2019 Institute for Business Communication* July 2019 July 2021 July 2020 PERSONAL INFORMATION Name: FAMILY NAME FIRST NAME MIDDLE NAME Date of Birth: Month: Day: Year: (You must be at least 17 years old on the first day of the program.) 8-digit Penn ID (if available): Country of Citizenship: Native Language: Country of Birth: Permanent Address in Home Country: STREET ADDRESS CITY STATE POSTAL CODE COUNTRY Home Telephone: Student Email: PLEASE SEND ALL INFORMATION AND I-20 TO Home address above OR to Agent/Sponsor below If you are a transfer student, please supply us with a local U.S. address below. Agent/Sponsor (if applicable): Agent Contact Name: Mailing or Agent/Sponsor Address: STREET ADDRESS CITY STATE POSTAL CODE COUNTRY Telephone: Agent Email: PAGE 1
UNIVERSITY OF PENNSYLVANIA ENGLISH LANGUAGE PROGRAMS ENROLLMENT FORM 2018-2019 FINANCIAL SUPPORT 1. Who will pay for your tuition and living expenses? Financial support document must show funds to pay the estimated tuition and living expenses for ALL sessions included Self on your I-20. Please send a statement showing sufficient funds Family in my home country for your study period. An organization, company, or government Name of Organization: Permanent U.S. resident (U.S. resident will be asked to complete an Affidavit of Support) Intensive/University Connection IAS/IBC Global Citizen: Full Program Global Citizen: Accelerated Program $8,885 per session $9,404 per session $4,764 per session $37,054 for program $19,648 for program VISA INFORMATION Please check one: I will apply for an F-1 student visa. Please send me an I-20 form. I will transfer my I-20 from another school. I am currently studying in the U.S. on an F-1 visa (Please see list of required documents on right). I have been admitted to another department at Penn. Name of Department: I do not need an F-1 student visa because: I am a U.S. citizen or permanent resident I have another type of visa that allows me to study in the U.S. Type of Visa: (Please send a copy.) Other: Transfer students must also send: Official transcript from current school Copies of student visa, I-20, and CBP admission stamp (or print-out of I-94 admission number) Local address in the U.S. Completed Proof of Academic Success Form (ELP will provide after you submit your application) Completed Transfer Form (ELP will provide after you submit all documents) DEPENDENTS Do you have dependents (spouse/children) that will come with you to the U.S.? Yes No Students with dependents must include a copy of each dependent s passport. Write the dependent s country of birth, country of citizenship and relationship to you on the passport copy. Financial support document must include an extra $550 per month per dependent. UNIVERSITY CONNECTION & UNIVERSITY CONNECTION PLUS STUDENTS ONLY 1. Which program are you applying to? University Connection (UniConn Plus requires TOEFL ibt: 70) Your current TOEFL Score: Sessions you would like to take UniConn Plus: 2. What is your field of study/major? 3. Which degree are you seeking? Bachelor s Master s Doctoral 4. When do you plan to start your degree program? 5. Please list any college or universities you attended in the past or are attending now. (Include school name, location, enrollment, dates, degree) PAGE 2
UNIVERSITY OF PENNSYLVANIA ENGLISH LANGUAGE PROGRAMS ENROLLMENT FORM 2018-2019 INSTITUTE FOR ACADEMIC STUDIES & INSTITUTE FOR BUSINESS COMMUNICATION STUDENTS ONLY Home University: Field of Study: HOW DID YOU HEAR ABOUT ELP? REFUND POLICY Before classes start, students can receive a refund of tuition and fees minus the non-refundable $90 enrollment fee and the $310 tuition deposit. Before the first week of classes end, students can receive a refund of 75% of tuition minus the $90 enrollment fee and $310 tuition deposit. Fees, insurance and housing are governed by separate policies and may not be refundable depending on when you withdraw. SIGNATURE I certify that I have read and understand the information in this form, including the refund policy, and the information I have provided is accurate and complete. I understand that enrollment in this program does not constitute admission to any other program at the University of Pennsylvania. YOUR SIGNATURE DATE Application Checklist: Enrollment form (pages 1-3) Photocopy of passport (name, date of birth, and photo) Financial Support document (statement from bank or sponsor) Check, international postal money order, or traveler s check for $400 Non-refundable payment includes $90 enrollment fee and $310 tuition deposit Make payable to: Trustees of the University of Pennsylvania Electronic version of color passport photo (.jpg format: at least 300 x 380 pixels) Program-specific requirements (see details on pages 4-6) Additional documents for transfer students (see details on page 2) We recommend you apply at least 6 weeks before the start of your program to allow sufficient time to apply for and receive your visa. PLEASE SEND APPLICATION MATERIALS TO: English Language Programs University of Pennsylvania 110 Fisher-Bennett Hall 3340 Walnut Street Philadelphia, PA 19104-6274 USA Email: elp@sas.upenn.edu Phone: 1-215-898-8681 Fax: 1-215-898-2684 PAGE 3
UNIVERSITY OF PENNSYLVANIA ENGLISH LANGUAGE PROGRAMS Program Information 2017-2018 INTENSIVE PROGRAM UNIVERSITY CONNECTION UNIVERSITY CONNECTION PLUS Summer 2, 2018 June 27 - August 17, 2018 May 25, 2018 Fall 1, 2018 August 29 - October 19, 2018 July 13, 2018 Fall 2, 2018 October 24 - December 14, 2018 September 14, 2018 Spring 1, 2019 January 3 - February 22, 2019 November 16, 2018 Spring 2, 2019 February 28 - April 19, 2019 January 18, 2019 Summer 1, 2019 April 25 - June 14, 2019 March 15, 2019 Summer 2, 2019 June 27 - August 16, 2019 May 10, 2019 Fall 1, 2019 August 29 - October 18, 2019 July 12, 2019 Fall 2, 2019 October 24 - December 13, 2019 September 13, 2019 UNIVERSITY CONNECTION PLUS REQUIREMENTS Please send a test score as proof of your language proficiency: TOEFL ibt: 70 IELTS: 6.0 INTENSIVE UNIVERSITY CONNECTION UNIVERSITY CONNECTION PLUS ONE SESSION MULTI-SESSION DISCOUNT ONE SESSION MULTI-SESSION DISCOUNT $90 Tuition $4,540 $4,171 University Fees $535 $535 Medical Insurance $214 $214 TOTAL $5,379 $5,010 $90 $90 $5,059 $4,690 $535 $535 $214 $214 $5,898 $5,529 * Prices are valid through Summer 1, 2019 and are subject to change at the discretion of the Board of Trustees. The multi-session rate is applied when a student enrolls and pays in advance for 2 or more consecutive sessions. The enrollment fee is paid once per new enrollment. The multi-session rate is not available for the combination of the Summer 1 and Summer 2 sessions. INSTITUTE FOR ACADEMIC STUDIES (IAS) July 2018 July 2 - July 27, 2018 May 25, 2018 August 2018 August 1 - August 27, 2018 June 22, 2018 January 2019 January 14 - February 8, 2019 December 7, 2018 February 2019 February 11 - March 8, 2019 January 4, 2019 July 2019* July 8 - August 2, 2019 May 31, 2019 IAS REQUIREMENTS Please send a test score as proof of your language proficiency: Tuition $2,652 University Fees $239 Medical Insurance $107 TOTAL $3,088 * IAS prices are valid through March 2019 and are subject to change at the discretion of the Board of Trustees. TOEFL ibt: 40 IELTS: 5 TOEIC: 400 If you do not have a test score, please contact the ELP to take an online placement test. PAGE 4
UNIVERSITY OF PENNSYLVANIA ENGLISH LANGUAGE PROGRAMS PROGRAM INFORMATION 2018-2019 INSTITUTE FOR BUSINESS COMMUNICATION (IBC) July 2017 July 2 - July 27, 2018 May 25, 2018 August 2017 August 1 - August 27, 2018 June 22, 2018 July 2019* July 8 - August 2, 2019 May 31, 2019 IBC REQUIREMENTS Please send a test score as proof of your language proficiency: TOEFL ibt: 57 IELTS: 5.5 TOEIC: 550 If you do not have a test score, please contact the ELP to take an online placement test. Tuition $2,652 University Fees $239 Medical Insurance $107 TOTAL $3,088 * IBC prices are valid through August 2019 and are subject to change at the discretion of the Board of Trustees. GLOBAL CITIZEN STUDY ABROAD PROGRAM: FULL PROGRAM (GCP) SESSION DATES* APPLICATION DEADLINE Summer 2018 - Fall 2018 April 25, 2018 - December 20, 2018 March 16, 2018 Fall 2018 - Spring 2019 August 29, 2018 - May 14, 2019 July 13, 2018 Summer 2019 - Fall 2019 April 25, 2019 - December 19, 2019 March 15, 2019 Fall 2019 - Spring 2020 August 29, 2019 - May 12, 2020 July 12, 2019 GCP REQUIREMENTS Please send the following along with your completed application: Official university transcripts Test score as proof of language proficiency: TOEFL ibt: 74 IELTS: 6.0 TOEIC: 750 Students must successfully complete their ELP courses to be eligible to enroll in the GCP credit course. Students with prior academic integrity violations or criminal convictions may be denied entry into the program. ELP Tuition $15,442 LPS Tuition $3,616 - $7,004 University Fees $2,140 Medical Insurance $856 TOTAL $22,144 - $25,532 * Prices can be paid by session, semester, or in full. Prices are valid for for the Fall 2018 - Spring 2019 offering and are subject to change at the discretion of the Board of Trustees. Please use the above prices as estimates for future offerings. LPS course cost varies by course selected. Price breakdowns and updates are available on the ELP website. GLOBAL CITIZEN STUDY ABROAD PROGRAM: ACCELERATED PROGRAM (GCP-A) Fall 2018 August 27 - December 20, 2018 June 29, 2018 Spring 2019 January 3 - May 14, 2019 November 2, 2018 Fall 2019 August 27 - December 19, 2019 June 28, 2019 GCP-A REQUIREMENTS Please send the following along with your completed application: Official university transcripts Test score as proof of language proficiency: TOEFL ibt: 87 IELTS: 6.5 TOEIC: 850 ELP Tuition $7,100 LPS Tuition $3,616 - $7,004 University Fees $1,070 Medical Insurance $428 TOTAL $12,304 - $15,692 * GCP-A prices are valid through Spring 2019 and are subject to change at the discretion of the Board of Trustees. LPS course cost varies by course selected. Price breakdowns and updates are available on the ELP website. Students with prior academic integrity violations or criminal convictions may be denied entry into the program. PAGE 5