Personal information in USA
Address:
Telephones:
Gender*
Date of Birth
Personal information in country of residence
Date of birth-must be same as passport
Gender*
Address:
Telephones:
Dependents*
Gender*
Date of birth-must be same as passport
Gender*
Date of birth-must be same as passport
Gender*
Date of birth-must be same as passport
Arrival information for international students
Accommodation required Please note rates are subject to change
Program Choice
Check all the sessions (8 wks or 12 wks) that you plan to study below (if more then one please indicate which quarter you would like to start)
(private classes can be arranged on an as-needed basis) $460.00 per student ·16 hours of instruction $400.00 · Registration fee & Materials $60.00 · Placement test (Optional) $25.00
*Private class package requires the contract section of the application form to be signed.
International student package-minimum of 240 hours (3 months) per quarter is required · one time application fee of $100. 00 is not included in price
Program length 3 months ·240 hours of instruction $2, 400.00 · Placement test (Optional) $25.00
Program length 6 months ·480 hours of instruction $4, 800.00 · Placement test (Optional) $25.00
Program length 9 months ·720 hours of instruction $7, 200.00 · Placement test (Optional) $25.00
Program length 12 months ·960 hours of instruction $9, 600.00 · Placement test (Optional) $25.00
Contract for Private Classes
week(s)
INCONVENIENCE COMPENSATION CLASS CHANGE POLICY
All classes are scheduled per above. If the student wishes to change any of the scheduled classes, the Language school shall be notified at either by telephone, (813-932-0482), email or fax (813-980-3751) at least 24 hours (one full day) in advance of the scheduled class. Any changes made less than 24 hours notice will be considered Ќlate cancellationЋ and the student will be charged in full for the class.
COURSE CANCELLATION POLICY
If the student cancels a course less then 1 week prior to course start date or after course has begun, 2 days of scheduled instruction shall be charged, plus a $25 administrative fee.
Please sign and date below to indicate your acceptance of the terms of this agreement
Program Fee Payment-Please check and provide details
Cancellation and refund Policy for International students - If you cancel your course prior to the starting date you will be eligible for a refund of the prepaid tuition and lodging fees less 10% cancellation fee. Please note that the INS authorities will be notified immediately and your nonimmigrant student status will be terminated. After program commencement there is absolutely no program refund, unless for a medical emergency, in which a doctorђs certificate must be presented. The above refund policy will then apply. Refunds will be issued within 30 days after the cancellation date.
Educational advising service or agency (if applicable)
Freedom of Information - The information contained on this form and other documents and materials is used to support the admission and registration process. It is collected for the purpose of making admission and registration decisions, and for informing students of registration matters. If you have any further questions about the collection and/or use of this form please contact administration at 813-932-0482, 4815 E. Busch Blvd, Tampa, Florida, 33617.
DECLARATION (application will be returned if not signed below) …I certify that the information contained herein and that all statements made in connection with this application are true, correct, and complete. I understand that any misrepresentation, incomplete disclosure or falsified information on this application form may result in the cancellation of my admission or registration status. I agree the Tampa Language Center may verify the information provided.
I understand and agree to abide by the regulations and policies of Tampa Language Center as outlined
Certification information- to completed at end of student enrollment.
