LCI@RU Intensive English Program Application

Application

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* 1. Name EXACTLY AS IT APPEARS ON YOUR PASSPORT:

First Name(s)

Family Name

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* 2. Email Address:

Primary email address

Alternate email address

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* 3. Country of Birth

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* 4. Country of Citizenship

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* 5. Gender:

Male

Female

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* 6. Date of Birth:

	Month	Day	Year
Age requirement 17 or older	Age requirement 17 or older Month menu	Age requirement 17 or older Day menu	Age requirement 17 or older Year menu

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* 7. Permanent address (the address where you live):

Street

City

State/Province

ZIP/Postal Code

Country

Telephone

Fax

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* 8. Address where we will send your I-20:
(overseas applicants only, if different from permanent address)

Recipient Name

Street

City

State/Province

Postal Code

Country

Telephone

Fax

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* 9. Contact relative or friend in the U.S. (if any):

Contact Name

Telephone

....................................................................................................................................................................................................................

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* 10. Choose the term you plan to BEGIN study:

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* 11. How many terms do you plan to study?

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* 12. First-term housing preference:

Staying with family or friends

Homestay in an area home

Residence on campus (Main Campus ONLY, subject to availability & summer only)

Apartment (recommended for family)

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* 13. How did you find out about the Intensive English Program?

A friend or relative at Virginia Tech

A friend or relative at Radford University

Information at an educational fair

An advertisement in a magazine

On the AAIEP website

Through an Internet search

Through your company, a government office, an embassy or an educational agency (please provide contact name and email)

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* 14. Have you had English language training at other schools?
(check all that apply)

Elementary or secondary school

International or American school

School in an English-speaking country

Private language institute

Language institute in the U.S.

No formal English language training

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* 15. Current immigration status:

New Student Visa (F-1) Applicant

Student Visa Transfer

Business/Visitor Visa or Visa Waiver

U.S. Citizen or Resident Alien

Other (F-2, J-1, J-2, Refugee, etc.)/please specify

TELL US ABOUT YOUR PLANS
If you are planning to attend a college or university following your English language training, including Radford, please respond to questions 16-19.

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* 16. Why are you learning English as a second language?

To attend a U.S. college or university

For college or university in your own country

For business or career purposes

For pleasure

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* 17. What are your college or university plans?

Graduate studies at Radford University

Undergraduate studies at Radford University

Graduate studies at another college or university

Undergraduate studies at another college or university

Community college

Career or technical school

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* 18. If not Radford University, what school are you planning to attend?
(if unsure, enter "undecided")

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* 19. What major do you wish to pursue?
(examples: Bachelor of Science in Biology, Masters in Sociology, etc.)

F-1 TRANSFER DETAILS
Please complete the following section (questions 15-18) only if you are currently an F-1 student and will be transfering from another school.

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* 20. Name of the institution you are transfering from:

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* 21. Institution type:

English Language Program

Graduate Degree Program

Four-Year College or University

Community College

Other (please specify)

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* 22. Transfer institution contact information:

Advisor Name

Title (if known)

Email/Telephone

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* 23. U.S. address where we will send your transfer I-20:

Street

City

State

ZIP Code

Country

Telephone

Fax

NEW STUDENT VISA APPLICANTS AND F-1 TRANSFERS
Please complete the following section (questions 19-24) if your spouse and/or children will accompany you to the United States.

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* 24. Spouse:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 25. Dependent child #1:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 26. Dependent child #2:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 27. Dependent child #3:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 28. Dependent child #4:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 29. Dependent child #5:

Full Name

Sex (male/female)

Birth Date (mm/dd/yyyy)

Country of Birth

Country of Citizenship

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* 1. Name EXACTLY AS IT APPEARS ON YOUR PASSPORT:

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* 2. Email Address:

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* 3. Country of Birth

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* 4. Country of Citizenship

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* 5. Gender:

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* 6. Date of Birth:

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* 7. Permanent address (the address where you live):

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* 8. Address where we will send your I-20: (overseas applicants only, if different from permanent address)

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* 9. Contact relative or friend in the U.S. (if any):

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* 10. Choose the term you plan to BEGIN study:

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* 11. How many terms do you plan to study?

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* 12. First-term housing preference:

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* 13. How did you find out about the Intensive English Program?

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* 14. Have you had English language training at other schools?(check all that apply)

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* 15. Current immigration status:

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* 16. Why are you learning English as a second language?

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* 17. What are your college or university plans?

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* 18. If not Radford University, what school are you planning to attend? (if unsure, enter "undecided")

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* 19. What major do you wish to pursue?(examples: Bachelor of Science in Biology, Masters in Sociology, etc.)

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* 20. Name of the institution you are transfering from:

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* 21. Institution type:

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* 22. Transfer institution contact information:

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* 23. U.S. address where we will send your transfer I-20:

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* 24. Spouse:

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* 25. Dependent child #1:

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* 26. Dependent child #2:

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* 27. Dependent child #3:

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* 28. Dependent child #4:

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* 29. Dependent child #5:

* 8. Address where we will send your I-20:
(overseas applicants only, if different from permanent address)

* 14. Have you had English language training at other schools?
(check all that apply)

* 18. If not Radford University, what school are you planning to attend?
(if unsure, enter "undecided")

* 19. What major do you wish to pursue?
(examples: Bachelor of Science in Biology, Masters in Sociology, etc.)