Academic and Professional Program Application



The English Center
7700 Edgewater Drive
Suite 540
Oakland, CA 94621
Phone (510) 836-6700
info@englishcenter.edu

On-line U.S. Resident Application for the English Center

The following information will be sent directly to the English Center when you press the “SUBMIT” button. You will still need to mail or fax your financial certification information. Your I-20 and acceptance letter will be sent to you only when we have received the financial certification and application fees.

Please be sure to check the certification box at the end of the application, just after the credit card payment. Checking this box is the same as our signature on a written application.

Your Name:
Last or Family Name*
First Name(s)*
Middle Name
Email*
Your Address:
Street or Post Office Box*
City*
State*
Postal Code*
Your Telephone Number:*
Area Code
Number
Date of Birth*
Month Date Year
Gender* Male:              Female:
Mark the session in which you plan to begin your studies (refer to the Session Calendar & Fees)*
How many weeks do you plan to study at the English Center?
Immigration Status Information
Country of Birth
Country of Citizenship
Date Entered U.S.
Month Date Year
Postal Code
ID Type & #:
Most Recent Work Information

Employment status:

Employed
EDD UI=Yes
Never worked
Unemployed - Last worked:

Month Date
Education History Secondary (High) School:
How many years?
Did you graduate? Yes No

College or University:
How many years?
Did you graduate? Yes No

Please rate your current ability in English: None: Beginning: Low Intermediate:
High Intermediate: Advanced:

Where did you hear about the English Center?
Credit Card Payment:
Credit Card Payment: (If paying by cash or check, please pay in person at the English Center’s Business Office.)
Visa MasterCard
Name of Cardholder:
Credit Card number:
3-digit security code (reverse of card):
Expiration date:
Month Year
Amount:
US$100 Application Fee
US$200 SEVIS Fee
US$250 Homestay Fee

* I certify that all the information provided on this form is correct and complete. (Checking this box serves the same purpose as signing and dating a printed version of this application form.)

Acceptance documents will not be sent until we have received the application fee. The Admissions Office may request that you appear in person at the English Center to provide additional information. To make an appointment, please call (510) 836-6700 ext 131; or email admissions@englishcenter.edu.

          
The English Center
7700 Edgewater Drive
Suite 540
Oakland, CA 94621
Phone (510) 836-6700
info@englishcenter.edu

Copyright © 2017 The English Center