Day Telephone Number
Evening Telephone Number
Fax Number (optional)
Date of Birth (day-month-year)
Place of Birth (country, city):
Status and Visa Information
Are you NOW in the United States? Yes No
a. If your answer is yes, when did you come to the United States?
b. What type of visa do you hold?
If you are not in the United States at this moment, on which Visa do you intend to enter the United States?
I wish to book Weeks
I wish to start classes on: (Day) (Month) (Year)
I am applying for the following program at English Language School in Phoenix:
Intensive English ESL Courses:
Morning Intensive English course (20 group lessons a week)
Morning Intensive Plus English course (28 group lessons a week)
General English ESL Courses:
Morning English ESL Course (4 group lessons a week)
Afternoon Course (4 group lessons a week)
Evening Course (4 group lessons a week)
Saturday Course (4 group lessons a week)
Private General English Classes
Private General English ESL Course with one-to-one lessons per week (10 lessons minimum)
Private General English ESL Classes Comments:
American English Pronunciation & Accent Reduction:
American English Pronunciation & Accent Reduction 6-week program with 4 group lessons a week
I want to book American English Pronunciation & Accent Reduction program with the total number of one-to-one lessons (10 lessons minimum)
English for Specific Purposes Courses:
American Idioms and Vocabulary Building
English for Telephoning
English in the Workplace
English for Job Search Success
Practical English Writing Skills Workshop
English for Specific Purposes courses are offered as group classes with 4 lessons per week for 6 weeks and as one-on-one lessons with flexible schedules. Please select one of the following:
I want to attend the selected English for Specific Purposes course(s) for 6 weeks in group
I want to book the selected English for Specific Purposes course(s) with the total number of one-to-one lessons (10 lessons minimum)
Test Preparation Courses:
Test Preparation Courses are offered as group classes with 4 lessons per week for 6 weeks and as one-on-one lessons with flexible schedules. Please select one of the following:
I want to attend the selected Test Preparation course for 6 weeks in group
I want to book the selected Test Preparation course with the total number of one-to-one lessons (10 lessons minimum)
English Courses for Executives and Professionals:
Mini-Group Courses for Executives and Professionals:
Mini-Group Course for Executives and Professionals with 20 lessons a week in the morning.
Mini-Group Course for Executives and Professionals with 20 lessons a week in the afternoon.
I also want to book additional 10 one-to-one lessons per week
Private One-to-One Courses for Executives and Professionals:
Private Executive English Course with 15 one-to-one lessons per week
Private Executive English Course with 20 one-to-one lessons per week
Private Executive English Course with 25 one-to-one lessons per week
Private Executive English Course with 30 one-to-one lessons per week
Private Executive English Course with 35 one-to-one lessons per week
All English courses for Executives and Professionals are tailor-made and include development of your general English language skills, remedial work on pronunciation and accent reduction and vocabulary building and writing skills, specific to your profession, as well as English for Specific purposes: telephone skills, meetings, presentations, etc. Upon registration we will send you the Executive Course Needs Analysis that will help us assess your requirements and formulate a unique program tailored to your needs.
Please select your program specialization:
Business English for Executives
General Executive English tailored to my specific learning needs
English for Accounting & Finance
English for Automobile Industry
English for Aviation
English for Customer Care
English for Human Resources
English for Law Enforcement
English for Logistics
English for Marketing & Advertising
English for Military
English for Sales & Purchasing
English for Meetings
English for Presentations
English for Socializing
Executive English Course Comments. Please enter any comments below regarding your learning goals.
I also want to book English Classes Outside Classroom (min. 10 hours a week)
This program can be booked only in addition to any of our group and/or private courses.
Please enter the number of hours per week :
For how long have you studied English?
What is the student's present level of English?
Your English Learning Goals:
Do you want us to arrange Accommodations for you?
If yes, please select one of the following options:
Accommodation arrival date:
Accommodation departure date:
All accommodations are subject to availabilty.
Do you have any allergies?
Smoking is allowed only outside the residence.
Do you have any allergies?
If yes, please list:
Please give details of any special requirements relating to accommodations:
Do you want us to arrange airport transfer for you?
If yes, please select one of the following options:
Arrival and departure.
Please supply flight arrival information:
Arrival Time: (24 hour clock)
Airline and flight number:
A non-refundable application fee of US$50.00 ($100.00 if you apply for the Executive course) and the tuition deposit of $200.00 are required with your application. Please note that your application will be considered only when your payment of the application fee and the tuition deposit has been received.
Upon receiving your application and your payment of the application fee and the tuition deposit, we will send you a registration confirmation and invoice.
The payment of the balance of fees is due upon receipt of invoice. Your place will be confirmed only when the full payment has been received. The full payment must be paid before we can issue documentation in support of a visa application if required.
You may pay the balance by wire transfer, check or money order, or by credit card.
Please note that you may apply online only if you pay the application fee and the tuition deposit by credit card.
You can also print out a from your browser, fill in your application and send it by post or by fax. If you use the printable application form, you can make your payment of the application fee and the tuition deposit by credit card, check or international money order or by wire transfer to our bank account.
printable application form in PDF
Payment by Credit Card
We accept VISA and MasterCard. In this Form, we utilize the Secure Socket Layer (SSL) authentication and RC4 128 bit encryption technology. SSL encryption protects information being transmitted across the internet to our processing center.
Please charge the application fee of US$50.00 ($100.00 if you apply for the Executive course) and the tuition deposit of $200.00 to my credit card provided below.
Please charge the application fee and the full payment to my credit card provided below.
Even if you select a "full payment" option, we will charge only the enrollment fee and the deposit at the time of accepting your application and will process the payment of the balance to your credit card after registering you for the program. Please also note that if you would prefer to pay the balance by credit card, a 4.5% convenience payment processing service fee will be included in the invoice. There are no any additional charges on your payment of the application fee and the tuition deposit by credit card.
Please select credit card:
(Month) / (Year)
Card Verification Value*:
* the last three digits on the back of your credit card after the credit card number. This value protects you from online fraud by verifying that you are in possession of the card you are attempting to use.
Cardholder Billing Information:
Zip (Postal) Code
Agreement and release.
By submitting this Application, I certify the above information is complete and correct. I understand that my misrepresentation may result in my expulsion from the program. I acknowledge that the terms and conditions appearing on the Study Abroad International web site constitute part of my agreement with IPSA and study abroad program host (university, college, language school, or other institution and/or organization), including sections concerning responsibility, health, refunds, changes in dates, accommodations, courses and billing of the selected options; I assume all risks and responsibilities and discharge IPSA and the study abroad program host and all their officers, agents and employees from and against any and all claims of damage to personal property or personal injury which may result from my enrollment and participation in the study abroad program host courses, excursions, and/or on and off-campus activities. I have read all terms and conditions and rules and agree to follow all IPSA and study abroad host procedures and regulations. This Agreement will be effective when my application is accepted by IPSA and shall be governed by the laws of the State of Florida, USA.
Yes, I agree.
I don't agree