English Language Center Application Form

1
English Language Center Application Form
Name __________________
_______________ ___
Family Name
First Name

MI Address _____________________
_____________________________
_______________________________________________
___ _________________________________________
_________
__________________________________________________
Phone _________________
Fax (if available)___________ E-mail
_________________ Date of Birth
___________ Home Country _____________
Country of Citizenship ___________ Gender
Male ? Female ? Experience
(check all that apply) University
? Work Experience ? High School ?
Program you are applying to (check one)
Intensive English ? Business
Case ? Pre-MBA ? American
Classroom ? University Acceptance ?
Legal English ? Global
Leadership in Boston ?
See other side of this page for
application requirements and starting dates to
complete your application.
Visa Status International ?
Transfer from ? Northeastern Program ?
Other? (from abroad)
US School Change
TOEFL Score (if available) _____________
Mail Completed Application to

www.cps.neu.edu/elc
2
Check the program starting date you want and
prepare application requirements.Go to the
application webpage for each program for detailed
instructions.
Intensive English Program
2-month Sessions
Business Case Program
Pre- MBA Program 2-month
Sessions
8 or 4-month Programs
University Acceptance Program
4 or 8-month
Programs
Global Leadership in Boston 1-Month Program
__ July 6 July 31, 2009 Application
Requirements Application, DCF, Bank Statement,
Essay, One-page resume of work and academic
experience, Passport Photo, 250 tuition deposit
American Classroom 8 or 12-Week Quarters
Legal English Program12-Week Quarters
__ Fall Quarter Sept. 14 Dec. 12, 2009 __Winter
Quarter Jan. 11 March 24, 2010 __Spring
Quarter April 12 June 28, 2010 Application
Requirements Application, DCF, Bank Statement,
Essay, Passport Photo, 250 tuition deposit
Revision 3-20-09