Kent State University ESL Admissions Form

Check the semester for which you are applying: Spring Summer Fall 2006 2007 2008
Summer Program Number: NA 1 2 3 4 5 6 7 8
Last (family) name:	e.g. Jones, Franco, Suzuki, Dicko
First name:	e.g. William, Fabien, Keiko, Mody
Email:
USA Information (if available)
Street:
City:
State:
Zip:
Phone Number:
Home Country Information
Street:
City:
Province:
Country:
Postal Code:
Phone Number:
FAX Number:
Personal Information:
Birth date (month/day/year):	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 example: April 22 1986
Gender (male/female):	Male Female
Additional Information:
What type of visa will (do) you have:
	F1 F2 J1 J2 H B Refugee Other (explain):
Country of Citizenship:
Country of Birth:
I plan to apply to an American University in the future:
	Yes No Unsure
I plan to take the TOEFL (or MELAB) exam during:
	Spring Summer Fall 2006 2007 2008
I will need a dormitory room:
	Yes No
I will need transportation from the airport:
	Yes No
I will be a:
	Full-time student (20 contact hours of ESL classes per week or more during the Fall and Spring semesters; special requirements apply for the summer programs) If you will have an F1 or J1 visa, you must be a full-time student. Part-time student (less than 20 contact hours of ESL classes per week during the Fall and Spring semesters)
Financial Verification:
The ESL Program at Kent State University is required by the United States Immigration and Naturalization Service to obtain evidence that each applicant has adequate funds to pay for educational and living expenses during the time of study. IMPORTANT: We require the actual paper copy of the information below. You should complete the information below, but it is very important that you send the actual paper copy of your financial information to us in the mail!
Choose one source of funds:
	Personal Funds Documentation Required: Bank statement, signed by official, stating exact amount of funds available.
	Guarantor Documentation Required: Bank statement, signed by official, stating exact amount of funds available. Signature of guarantor on the application.
	Scholarship Documentation Required: Copy of scholarship or fellowship award letter or government authorization.
	Other Documentation Required: Document, such as a loan agreement, signed by a responsible official, stating exact amount of funds available.
Amount of Funds Guaranteed for Period of Study:
If a guarantor will provide your funds, please complete the following:
	Guarantor's Name: Phone Number:
Application Completion:
Admission application fee: $30.00
Any Questions or Comments?
If you are finished, press Send Application once, then return to the ESL Center main page.

If you have problems, use the text application HERE.

Kent State University, Department of English, ESL Programs, PO Box 5190, Kent, Ohio 44242-0001

Please note: This application is for admission to the ESL Program and its courses only. It is not an application for admission to Kent State University graduate or undergraduate programs.