Family
Name:
Given Name:
Address:
City/Country:
Telephone:
Sex:
Fax:
E-mail:
Date
of Birth: Month
Day
Year
Country
of Birth:
Native
Language:
Country of Citizenship:
If
student is under 18 years of age, a parent must complete
the following information and sign a medical consent
form.
The form will be sent upon registration and the original
must be returned prior to arrival.
Parents' Names:
Address
City/Country:
Parent's
Signature:
(Type your full name)
How did you hear about The Language Exchange International
English Center?
Date
you wish to begin your studies:
Number of weeks you wish to study:
Please
choose most appropriate level:
Please
choose the program you wish to take:
Please
choose the primary location of your choice:
The
Language Exchange International English Center is closed
on: New Year's Day, Martin Luther King Day, Presidents
Day, Good Friday, Memorial Day, Independence Day, Labor
Day, Thanksgiving Weekend and Christmas Day. Classes
are not recoverable for these dates.
FINANCIAL
STATEMENT FOR I-20 STUDENT VISA
If you wish to receive an I-20, please complete this
section. An I-20 is required for all students
taking an Intensive English Program. If
you are 18 years of age or older you may complete this
yourself. If you are under 18 years of age your sponsor
must complete the following:
"I agree to accept full financial responsibility
for the above-named student during the time he/she is
studying at The Language Exchange International English
Center."
Name:
Address:
Telephone:
Relationship to Student:
Signature:
(Please type your full name) Date:
PLEASE
COMPLETE THE FOLLOWING INFORMATION (U.S. DOLLARS)
Please
enclose your check made out to The Language Exchange
International.
Please contact us directly for
information on how to send payment via wire
transfer.
Phone: (561) 368-3913 Fax:
(561) 368-9380
info@LanguageExchange.com
Students
must present proof of insurance before classes begin
or they will not be permitted to attend. If a student
does not already have valid insurance, they must purchase
insurance through The Language Exchange International
at the student's expense. Students requesting an I-20
Visa must enclose full payment for their entire stay
before an I-20 Visa form can be issued.
If
a student withdraws from a course before the course
begins, all tuition less the $100.00 registration
fee will be refunded. If a student withdraws from
a course once it has begun and has completed 50% of
the course, the School will retain the full tuition.
If a student has completed less than 50% of the course,
the School will retain up to four weeks tuition in
addition to classes taken. If the school is unable
to find suitable accommodations, the School reserves
the right to withdraw its offer to provide accommodations
for a student. In such a case the School refunds all
prepaid accommodation fees. If a student withdraws
the request for accommodations prior to the selected
course starting date, the School refunds all prepaid
accommodation fees, less a cancellation fee of $50.00.
A student must give LEI 4 weeks notice to change or
cancel any homestay arrangements. There are no refunds
on stays of less than 4 weeks.
Private
instruction students are required to give at least
a 24 hour notice of cancellation. No-shows and late
cancellations will be charged to the private student
at the rate of one lesson for every class missed.
The
Language Exchange International reserves the right
to substitute two lessons of private or semi-private
instruction for four lessons of group instruction
should there be fewer than three students in any given
level.
