Application Form

Level placement tests are given every Thursday afternoon at each school location.

Personal Information
First Name:	*
Last Name:	*
Country of Citizenship:	*
Country of Birth:	*
Address:	*
City:	*
Zip Code:	*
Country:	*
Phone:	*
Fax:
Email:	*
Employer/School Name:
Occupation:
Emergency Contact Number:	*
Date of Birth (mm/dd/yyyy):	*
Gender:	Male	Female
How did you hear about us?	*
(If someone referred you to our school, please indicate their name.)
(If you found us on a search engine, please specify which search engine you found us on.)
> Choose Your Program:
I Will Attend:
(Non-Refundable US $95.00 Registration Fee)
Desired course starting date (mm/dd/yyyy):	*
Number of Months:	*
Campus:
(Acceptance on the desired starting date is subject to availablity)
Level of English:
Desired accommodation:
(Placement Fee: US $150.00 Special California)
> Options:
Airport Transfer (US $50.00)
> Method of Payment:
Wire Transfer		The following is the information requested concerning your wire transfer: WELLS FARGO ACCOUNTS IAE San Diego 5635631723 Fashion Valley 8912480483 La Jolla 8734194411 LV East 5635631780 LV West 6452708131 SSU SSU La Jolla 5077111572 SSU New Port Beach 7655659493 SSU Pacific Beach 7655659501 SSU MBA/BBA 5077111564 Wire Beneficiary: Tepper Technologies Inc. & International Academy of English 1729 5th Avenue San Diego, CA 92101 (Note: Wells Fargo Bank charges $15.00 for the wire transfer fee. Be sure to include this amount in the total fee.)
- Visa
- Mastercard
- Amex
Card Number:
Expiration Date (mm/dd/yyyy):
(Payment By Visa / MC Will Add a 3% for Transaction Fee. Payment By Amex Will Add a 3.5% for Transaction Fee.)

Additional Comments:


required field are marked with an asterisk (*)