Professional Documents
Culture Documents
Language Institute
Section 1: Personal Information
Full Name:
Last (Family) First Middle Month/Day/Year Country of birth Country of citizenship Native language
Sex:
Male
Female
Date of Birth:
Contact Information:
Telephone (Where you can be reached) Fax Email
Are you currently in the United States with an I-20 and plan to transfer?
Yes
No
No
Section 3: How did you hear about Georgia Techs Language Institute?
Former student
Name:
Agency
Please specify:
A friend told me about it Study in the USA website International study fair in my country
Fall 1 2011
(Aug 22 Oct 14)
Fall 2 2011
(Oct 24 Dec 16)
Spring 1 2012
(Jan 9 Mar 2)
Spring 2 2012
(Mar 12 May 4)
For Non F-1 Students Do you wish to study full-time or part-time? Which courses would you like to take? For Part-time Students
Section 5: What is your main reason for studying English in the U.S.?
to prepare for undergraduate study in the U.S. to prepare for graduate study in the U.S. to get a better job for social reasons other:
Financial declaration: The approximate cost of one 8-week session at the Language Institute Intensive English Program is $4,652. This cost includes tuition, fees, books, accommodations, insurance, and meals on campus. An additional $1,000 per session is required for each dependent included on the Form I-20. Please include a bank letter. See Instructions for preparing a Bank Document on our website. Name and address of person or organization responsible for the payment of your expenses:
Last (Family) City First Country Address Postal Code Telephone Fax
Do you want to include your spouse and/or children on the SEVIS Form I-20? Yes No If yes, please provide the following information and submit a copy of the passport I.D. page for each person (Attach additional
sheets if necessary)
Section 9: Where do you want us to mail your I-20 and acceptance package?
Name City State Number/Street Country Postal/Zip Code Telephone
If you have questions about your application call 404-894-2425 or e-mail apply@esl.gatech.edu