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Application Form - San Diego

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:
(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:
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:

Bank Name: Wells Fargo
Account Number: 5635631723
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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