The English Language
Institute (ELI) offers full-time and part-time courses for intermediate and
advanced students of English as a second language.
A. APPLICATION FOR 20____
PLEASE
CHECK ONE OF THE FOLLOWING:
INTENSIVE
PROGRAM: Fall___
Spring___ Summer___
EVENING
CLASS (part-time only): Fall___ Spring___ Summer___
PROFESSIONAL
AND ACADEMIC ENGLISH PROGRAM: Summer___
OTHER
(please write which one):
B. PERSONAL INFORMATION
Name
_________________________________________________________________________________
(Family
name) (First
Name) (Middle
Name)
Sex: Male____ Female____ Birthday
_______/_______/_______ (month/day/year)
Country of Birth
____________________ Native
Language ___________________Country of Citizenship ______________________
U.S. Social Security
number or Pitt ID number (if available)
________________
Address in Home Country:
Street
Address ________________________________________________________________
City
_________________________________ Province/Territory ____________________________________
Postal
Code__________________________ Country
________________________________________
Telephone
_____________________ Fax ____________________ E-mail _________________
Mailing Address (if
different from address in home country):
Street
Address ______________________________________________
City
_________________________________ Province/Territory _______________________________
Postal
Code__________________________ Country
________________________________________
Telephone
_____________________ Fax ____________________ E-mail _________________
Please include
a copy of the first page of your passport.
C. ACADEMIC INFORMATION
The English Language
Institute (ELI) requires proof that students have finished high school. You
must include proof of high school graduation or attendance at a college or
university.
Please check the document included: _____ Proof of
high school graduation
_____
Proof of attendance at a college or university
High school (include
name, city, country, and year completed):
___________________________________________________________________________________________
College/University
(include name, city, country, and year completed):
___________________________________________________________________________________________
D. I-20 APPLICATION FOR
AN F-1 STUDENT VISA
|
If you are in the U.S. now: |
If you are outside of the U.S.: |
|
What kind
of visa do you have? ____student (F-1) ____ visitor (B-1/B-2) ____ exchange visitor (J-1/J-2) ____ work (L or H) ____ resident ____ other (what kind?
________________) |
What visa will you use to enter the
United States? ____student (F-1) ____ visitor (B-1/B-2) ____ exchange visitor (J-1/J-2) ____ work (L or H) ____ other (what kind?
________________) |
1a. I will need a student (F-1) transfer
from another school in the US. YES _____ NO _____
1b. I will need an I-20 from the ELI for a
student (F-1) visa. YES
_____ NO _____
1c. I will need an I-20 form for dependents
(spouse and/or children) YES _____ NO _____
If
you need a form for dependents, please provide the following information
(continue on a separate sheet of paper if necessary):
Name Date
of birth Country
of birth Country
of citizenship Gender Relationship
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
2. If you need
a student (F-1) visa, you must complete both sections (a) and (b) below. The ELI will send you an I-20 form for
your F-1 visa
a. How will you pay your tuition and
personal expenses? (please check one)
___ Personal funds
___ My family in my home country (provide
name below)
___ Family or person in the US (provide
name below)
___ Scholarship from sponsor organization
(provide name below)
Name
of sponsor ________________________________ Relationship:
_________________
Address _______________________________________________
_______________________________________________
_______________________________________________
Telephone ____________________ Fax _____________________
Email ____________________
b. Financial guarantee information
You must include a
financial guarantee with this application in order to receive an I-20. The required bank statements must prove that you have
enough financial support for one year.
The required figures on the bank statement are:
á
For
regular ELI program: US $9,500 (per term) available for tuition and personal
expenses.
á
For
short summer programs: US $5,500
á
For
dependents: Please see our web page for exact amounts:
http://www.eli.pitt.edu/GENINFO/eliadmission/dependentrequirements.html
What kind of financial
guarantee are you providing?
Please check one.
_____ A
current, original bank statement in your own or your parentsŐ name
_____ A
current, original scholarship award letter from your sponsor organization. This
scholarship letter must state that your sponsor will pay for English
courses and personal expenses.
_____ A current, original bank statement from a personal sponsor in the US AND a letter from your sponsor stating that the sponsor will be responsible for your tuition and personal expenses.
E. Before signing this
application form, please read and check all the statements below.
___ I understand that there
is no beginning level course at the ELI.
___ I understand that I
must have enough money to pay my tuition and personal expenses while I am in
the US
I have
included:
___ proof of
high school graduation or attendance at a college or university
___ a copy
of the first page of my passport
___
financial guarantee information in order to obtain an I-20 (if needed)
___ a letter
from my personal sponsor in the US stating that the sponsor will be responsible
for my tuition and living expenses (if needed)
I have
included all necessary fees and payments made payable to the University of
Pittsburgh.
___ $200
nonrefundable deposit toward ELI tuition OR $500 nonrefundable deposit for PAEP
(required)
___ $50 nonrefundable
application fee (required)
___ $50 for express mail
(if needed)
___ optional PCIV
services (see PCIV
information)
$________________________
total amount enclosed
CHECK MUST BE IN US DOLLARS OR DRAWN ON A US BANK
Signature of
applicant________________________________ Date_________________
Print out and complete this
application form. Then, send by airmail the completed application form, the
academic information documents, financial documents (if needed), the deposit,
and application fees to:
Admissions Officer
English Language Institute
Department of Linguistics
2816 Cathedral of Learning
University of Pittsburgh
Pittsburgh, PA 15260 USA
F. How did you learn
about the
ELI?_________________________________________________________________________________
YOU CAN NOW PRINT YOUR APPLICATION, SIGN IT, AND MAIL IT TO:
English Language Institute
Department of Linguistics
2816 Cathedral of Learning
University of Pittsburgh
Pittsburgh, PA 15260
Telephone: 412.624.5901
Fax: 412.624.6130
Updated February 15, 2008