All Campus Application Please complete this form and submit to admissions@esli-intl.com with all required documents attached. Which ESLI campus would you like to attend? ESLI at Southern Illinois University Edwardsville ESLI+ Pathway Program * ESLI at Sullivan University Louisville, KY ESLI at Trinity Western University Langley, B.C. (Canada) Direct Entry Undergrad (minimum TOEFL 88 {21 all bands} or IELTS 6.5 {6.0 Writing})** Direct Entry Graduate (minimum TOEFL 100-105 or IELTS 7.0-7.5 all bands. http://www.esliadmin.com/detwu18.pdf for more information)** ESLI at University of Minnesota Duluth Fast Start Pathway Program * ESLI at University of Wisconsin Superior ESLI at Western Kentucky University Bowling Green, KY Conditional Admission to an Undergraduate Degree Program Conditional Admission to a Graduate Degree Program English Only (Qualifying students may apply to a university program while attending ESLI) How did you find ESLI? Website Friend Student/Academic Fair Agent If agent, please provide us with your agent s information: Name of Agent or Admissions Counselor Name of Agency Agent s email address Agent s phone City Country
Student Information: Last Name First Name Middle Name Gender: Male Female Date of Birth Country of Citizenship Country of Birth Student s email address Student s phone number Are you currently in the U.S. or Canada? No Yes. I am currently in/ studying in the U.S. If yes, please attach a copy of your most recent I-20 Yes. I am currently in/studying in Canada. If yes, please attach a copy of the visa you are using to remain in Canada. When would you like to start ESLI? Summer 2019 Fall 2019 (UMD,UWS, SU only) TWU student? Interested in one of TWU s Accelerated or First Year options? UT1 (support for the transition to university) IDC (must have a degree or equivalent) Which program would you like to apply to? Please refer to ESLI s website for a list of offered programs. For more information: http://www.esliadmin.com/auo.pdf
Have you taken the TOEFL or IELTS exam? No Yes If yes, please attach your official score results. Students who submit TOEFL or IELTS scores may qualify for Pre-Placement. See Complete details at www.esliadmin.com/ah.pdf (p. 7) Will family members accompany you? No Yes If yes, list dependents who will accompany you as F-2 visa holders. Relationship Full name Gender Date of birth Country of birth Country of Citizenship Foreign Permanent Address Street Address Street Address Line 2 City Province/State Postal/Zip Code Country
Foreign Mailing Address is: The same as my foreign permanent address Different from my foreign permanent address Street Address Street Address Line 2 City Province/State Postal/Zip Code Country Emergency Contact Information Name Phone
Financial Information I certify that I am financially able and willing to support the student named in this application while he/she is pursuing a course of study at ESLI. I hereby guarantee to provide sufficient funds to pay for the tuition, fees, medical insurance, living and personal expenses for the duration of the student's study. Further, I understand that I will have to provide an updated bank statement in order for the student to matriculate after he/she completes ESLI. In some cases, the bank statement for the university will require additional funds. (Please refer to page 8 for required amounts) Sponsor s Last Name Sponsor s First Name Relationship to Student Sponsor s Signature Education Information List in chronological order each school or institution you have attended; begin with high school (secondary school) and end with the present. Include all institutions attended, the dates attended, the degree(s) / certificate(s) / diploma(s) received, and your age when you attended. Failure to include a previous institution may result in cancellation of application/admission. Name of School Start Date End Date Degree Awarded
Terms & Conditions Please read this information very carefully before you sign it. Enrollment Agreement: An application fee and transcript evaluation fee are payable at the time of application. These fees are not refundable. ESLI requires that you transfer payment (by wire or credit card) as per the invoice provided, at least 2 weeks before the commencement date as listed on the I-20. Tuition and all fees are payable at the commencement of orientation unless arrangements have been made for billing your government sponsor. Please review the ESLI Refund Policy: https://www.esli-intl.com/terms Full Disclosure of Costs and Scholarship Information: I understand that information pertaining to ESLI costs and scholarship criteria are available at www.esli-intl.com and that it is my responsibility to review this information and seek further clarification before making any commitment to studying at ESLI. I fully acknowledge that while ESLI provides the most up-to-date information related to costs and scholarship opportunities, such information can change with or without notice at any time. I hereby fully release ESLI from any blame or liability due to any changes in this regard. General Policy (All Documents) Failure to submit complete, accurate, and authentic application documents may result in denial/cancellation of admission, or in the case of a current student who is found to have previously submitted fraudulent documents, expulsion. TOEFL and IELTS Verification Procedure Before pre-placing a student, ESLI sends all score reports to TOEFL or IELTS for official verification. TOEFL or IELTS reports their official findings regarding the validity of the documents to ESLI. If the documents are valid, the preplacement process continues. If the documents are deemed fraudulent, i.e. TOEFL or IELTS official response is that the submitted reports do not match the results in their database, ESLI reserves the right to cancel the application completely, and the applicant forfeits any application fees paid. ESLI reserves the right to report any incidence of fraud to its partner school officials. Online Application Policy I give permission to ESLI to transfer my application information to a partner university for admission. I also give ESLI permission to complete additional documents on my behalf. I understand that, as part of the process, ESLI may create a login ID and password for me for a university on-line application website. I certify that I am: 18 years old (or older) and completing this application on my own behalf. 18 years old (or older) and completing this application on behalf of the student named in this application who is under the age of 18. I am fully authorized to provide information on behalf of this student. Student Agreement: By signing this document, I acknowledge that I have read and understood this Enrollment Agreement, Refund Policy and Full Disclosure of Costs, Scholarship Information, General Policy (All Documents) and TOEFL and IELTS Verification Procedure. I hereby accept and agree to all terms and conditions as set forth. In addition, I hereby acknowledge that all information contained in this application is true and accurate to the best of my knowledge. Signature