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Application Form - La Jolla
English Language School - English Courses, Intensive English Courses to pass the TOEFL, Business English and more. The premier English language school in San Diego and Las Vegas, the International Academy of English offers a full service English language school solution.
Assessment Test are given on Thursdays at 2:00 pm
> Personal Info:
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:
Choose a Program
English Intensive I
English Intensive II
TOEFL
(Non-Refundable US $75.00 Registration Fee)
Desired course starting date
(mm/dd/yyyy):
*
Number of Months:
*
(Acceptance on the desired starting date is subject to availablity)
Level of English:
Select Your Level:
Beginner
Intermediate
Advanced
Desired accommodation:
Select Your Accommodation:
International Studios Single Room
International Studios Shared Room
Homestay Single Room
Homestay Shared Room
Hotel (Available upon Request)
(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:
Bank Name: Wells Fargo
Account Number: 8734194411
Branch: San Diego - Clairemont
Routing Number: 121000248
Address: 4725 Clairemont Drive
San Diego, CA 92117
Wire Beneficiary: Tepper Technologies Inc. & International Academy of English
1729 5th Avenue
San Diego, CA 92101
(Note: Wells Fargo Bank charges $10.00 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 (*)
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