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:

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 LV East 5635631723 LV West 5635631723 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.)
*ALL PAYMENTS OF $100 OR MORE A $20 PROCESSING FEE IS APPLIED!
- Visa
- Mastercard
- Amex
Card Number:
Expiration Date (mm/dd/yyyy):

Additional Comments:


required field are marked with an asterisk (*)