International Student Application Form

STUDENT FULL NAME, AS APPEARS ON PASSPORT

Last Name

First Name

Middle Name

Date of Birth:

Select Program

Select Length of Your Program

Weeks

Months

Desired Start Date

Registration Fees

Book Fees

Mailing Fees

Tuition Fees (Every 4 weeks)

TOTAL AMOUNT PAYMENT PLAN:

Method of Payment

Credit/Debit Card

Credit Card Number

Expiration Date (MM/YY)

CC Code

Name as It Appears on the Credit Card

Telephone Number (+Area/Country Codes

I, , hereby authorize Celebration Language Institute, Inc. to charge my credit/debit card above described, the total amount entered above, which I will receive on a detailed receipt or invoice printed or by E-mail.

SIGNATURE

Draw signature
Type signature

Clear

Signature Date

THE APPLICANT AGREES AND PLEDGES TO THE FOLLOWING:

I have read and understood the estimated cost to attend and study at CELEBRATION LANGUAGE INSTITUTE, INC - CLI. I have set aside enough funds to pay for all my expenses, including tuition, registration fees, health insurance, meals, housing, and other personal expenses. I dully understand that an F1 student must attend a minimum of 18 hours of class per week and follow all US F1 VISA rules and regulations. I further understand and agree to the school's refund policy, attendance policy, and the student code of conduct. I certify that all of the above statements are true and correct.

Student Name (First/Middle/Last)

Today's Date

INTERNATIONAL STUDENT APPLICATION FORM

TOTAL AMOUNT PAYMENT PLAN:

THE APPLICANT AGREES AND PLEDGES TO THE FOLLOWING: