Application FormPlease fill out all fields in the application in ENGLISH. Please type or print in BLOCK CAPITAL LETTERS and in INK.

Application Fee and TuitionIn order for your application to be processed, you must include a non-refundable application fee AND a tuition prepayment with your application form (see 2017 Prices & Dates).

Financial Certification Each application requires financial certification, IN ENGLISH, if requesting a Form I-20. This means you must provide proof that you will have enough funds to meet your living and tuition expenses, as well as living expenses for any family members who might travel with you on student-dependent (F-2) visas. Any ONE of the following is acceptable:

a) A current personal bank statement or an original letter from your bank, OR

b) Both a letter/affidavit of support from your parents or other source of support stating that they will be responsible for your expenses during your stay at ELS, AND a bank statement verifying their financial ability to meet your expenses, OR

c) A letter guaranteeing financial support from your employer, OR

d) An original scholarship letter from your government or other organization.

What to send to ELS Completed and signed application form

Copy of biographical page of passport

Application fee

Tuition prepayment

Financial certification documentation (affidavit of support), in English, if requesting a Form I-20

Airport pick-up fee (if requested)

Housing deposit (if requested)

Express mail fee (if requested)

Send all correspondence and the completed application to:BY MAIL: ELS Language Centers Central Admissions

7 Roszel Road, Princeton, NJ 08540 U.S.A.

BY EMAIL: admissions@ELS.edu

Internal Use Only

Tell us about you!Name

Family Name (as shown on passport) First Name Middle Name

Gender Male Female

Address in Home Country

Street Address

City State/Province

Postal Code Country

Telephone (country and city code) E-mail

Personal Details

Date of Birth (mm/dd/yy) Country of Birth Country of Citizenship Mailing Address (if different than Home Address)

Street Address

City, State/Province Country Postal Code

Do you have any allergies? Yes No If yes, explain:

Do you have any medical needs? Yes No If yes, explain:

Do you have any special dietary restrictions? Yes No If yes, explain:

How to complete this application

2017 Application ENGLISH EDITION

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How did you learn about ELS? Counseling Agent Current ELS Student ELS.edu Friend Former ELS Student Brochure Family Facebook/Twitter Other

© Copyright 2017 ELS Educational Services, Inc. – a Berlitz company.

2017 Tuition by Program All tuition for the booked course must be paid prior to class attendance.

Program Prices per Course Lessons NumberTest-Prep Program Per Week of Weeks Tuition

Complete Prep Program for the TOEFL iBT® 30 12 $5,925

Complete Prep Program for the TOEFL iBT® 30 8 $3,970

Complete Prep Program for the TOEFL iBT® 30 4 $2,040*Program fee for the 12-week Complete Prep Program for the TOEFL iBT® includes tuition, materials, technology fee and seat for official TOEFL iBT®. 8-week and 4-week Complete Prep Program for the TOEFL iBT® includes tuition, materials and technology fee only.

Program Prices for a 4-Week Course Lessons Number Program Per Week of Weeks Tuition English for Academic Purposes 30 4 $1,840General English 30 4 $1,680Semi-Intensive English Program 20 4 $1,410Business English 30 4 $1,680American Explorer 15 4 $1,350

Currency All fees are listed in U.S. Dollars.

Application Fee A non-refundable $175 application fee ($100 for New York State Centers only: Hofstra, Manhattan, Riverdale and Rochester) is required with your completed application in order to process your enrollment.

Tuition Fee Tuition fees are as listed below. You must pay the tuition for the entire booked course before starting your program at ELS. A tuition deposit of 4 weeks is required for courses of 4 and 8 weeks and a tuition deposit of 6 weeks is required for courses of 12 or more weeks.

Housing Fee All housing fees are listed on pages 2-4 of this document. Housing prices are subject to change. A housing reservation deposit of $300 ($400 for New York – Manhattan) is required for each 4-week course ELS reserves your accommodations.

2017 Prices and Dates KEEP THIS FOR YOUR REFERENCE

Student Health Plan Fee All ELS students must have medical insurance coverage while in the U.S.A. If you cannot pro-vide evidence of sufficient coverage, in English, for medical expenses incurred while study-ing in the U.S.A., you must purchase the ELS Student Health Plan. The Student Health Plan is offered to ELS students at a non-refundable fee of $150 per 4-week course. Insurance for students on a J-program is $200 per 4-week course. You will receive additional information about the Student Health Plan when you arrive at the Center.

Airport Pickup Fee If you would like ELS to arrange airport pick-up upon your arrival, please indicate this under question 6 of the application form. The fees, by Center, are listed on the following pages of this document.

Materials and Technology Fee ELS, a leading English provider, offers you a unique curriculum that includes exclusive propri-etary textbooks and materials, as well as state-of-the-art Language Technology Centers. ELS will give you the appropriate textbooks and materials for each level you attend. Each student pays a non-refundable materials and technology fee of $95 at the beginning of each 4-week course attended. (Except for students in The Complete Prep Program for the TOEFL iBT®).

General Fees New York State Description ELS Centers Centers ONLYApplication Fee (one time) $175 $100

New York – ELS Centers Manhattan ONLYHousing Deposit (per 4 week course) $300 $400

International U.S./DomesticOptional Courier Service $110 $65

J-visa status 4-week course studentsHealth Insurance (per 4 week course) $150 $200

ELS Centers Materials and Technology Fee (per 4 week course) $95*

* Except for students in the Complete Prep Program for the TOEFL iBT®

English for Academic Purposes

General English

Semi-Intensive English

4 weeks $1,840

8 weeks $3,680

12 weeks $5,244

16 weeks $6,992

20 weeks $8,280

24 weeks $9,936

28 weeks $10,948

32 weeks $12,512

36 weeks $14,076

40 weeks $15,640

44 weeks $17,204

48 weeks $18,768

4 weeks $1,680

8 weeks $3,360

12 weeks $4,788

16 weeks $6,384

20 weeks $7,560

24 weeks $9,072

28 weeks $9,996

32 weeks $11,424

36 weeks $12,852

40 weeks $14,280

44 weeks $15,708

48 weeks $17,136

4 weeks $1,410

8 weeks $2,820

12 weeks $4,017

16 weeks $5,356

20 weeks $6,345

24 weeks $7,614

28 weeks $8,386

32 weeks $9,584

36 weeks $10,782

40 weeks $11,980

44 weeks $13,178

48 weeks $14,376

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Schedule A Schedule A – Housing and Airport Pick-up FeesA

Please note: Information is subject to change.X = Not applicableGE = Offers General EnglishBE = Offers Business EnglishiBT = Offers Complete Prep Program for the TOEFL iBT®CELTA = Offers CELTA CertificationTEFL = Offers TEFL Certification

* = Female only** = Male only+ = Additional deposit required – see Page 4 AY = Academic YearSM = Summer$ = Students receive a meal card with meal credits or pre-determined meal dollars

HR = Hanford Residence (Silicon Valley)HH = Hanford Home (Silicon Valley)PC = Park Circle Apartments (Silicon Valley)

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On-Campus Student Residence Off-Campus Student Residence Homestay

Atlantic City, New Jersey $1,100 D ALL X 17 X X X X X $975 14 17 $355 $315

EWRPHL

Berkeley, California X X X X X $1,360+ $1,040+

D

DALLALL

15X

1718 $1,200+ 14 18 $125 SFO

Bowling Green, Ohio $1,175 $950

S D ALL X

X1818 X X X X X $820 14 16 $200

$105DTW TOL

Cincinnati, Ohio $1,130+$1,130+

SD

ALLALL

XX

1818 X X X X X $955 14 18 $110 CVG

Clemson – Greenville, South Carolina X X X X X $640 S ALL X 18 $930 14 16 $70 GSP

Cleveland, Ohio X X X X X $920+ DD ALL X 18 $890 14 16 $85 CLE

DeKalb, Illinois $1,150 D ALL $ 18 X X X X X $900 14 14 $200 $180

MDW ORD

Denver, Colorado X X X X X $980+ S ALL X 18 $850 14 16 $120 DEN

Fort Wayne, Indiana $740+ S ALL X 18 X X X X X $800 14 16 $130 FWA

Grand Rapids, Michigan $850 $1,030

S SD

ALLALL

X X

1818 X X X X X $830 16 16 $80 GRR

Houston, Texas GE X X X X X $1,050+ DD ALL X 18 $990+ 14 14 $150 $150

HOUIAH

Kenosha, Wisconsin $970+ S ALL $ 16 X X X X X $890 14 16 $205 ORD

Lake Charles, Louisiana $875$650

S D

ALLALL

XX

1717 X X X X X $875 14 16 $530

$205HOULCH

Melbourne, Florida GE $1,430+ D ALL 19 18 X X X X X $955 14 14 $165 MCO

Nashville, Tennessee $640+ S ALL X 16 X X X X X $800 14 16 $85 BNA

New Haven, Connecticut X X X X X $1,170 D ALL 11 18 $985 14 17$250$225$225

EWRJFKLGA

New York – Manhattan, New York GE, BE, iBT X X X X X $1,725 $1,425

S D

ALLALL

X X

1818

$2,080 (inside Manhattan)

$1,350 (outside Manhattan)

7 18$135$135$135

EWRJFKLGA

New York – Riverdale, New York GE $1,300 T ALL $ 17 X X X X X $1,100 14 14$155 $155 $155

EWRJFKLGA

Orlando, Florida GE X X X X X $2,900 $1,600

S D

ALLALL

X X

1818 $1,140 14 16 $115 MCO

Philadelphia, Pennsylvania GE $1,350+ DD ALL X 18 X X X X X $1,120 14 17 $135 PHL

Richmond, Kentucky $630+ D ALL X 18 X X X X X $820 14 16 $110 LEX

Rochester, New York $1,410 S ALL $ 18 X X X X X $850 14 18 $95 ROC

St. Louis, Missouri $845+ S ALL X 16 X X X X X $845 14 18 $125 STL

St. Paul, Minnesota GE $1,510 D ALL 14 18 X X X X X $1,050 14 16 $135 MSP

St. Petersburg, Florida GE, TEFL $1,580+$2,200+

DDSD

ALLALL

1919

1717 X X X X X $1,175 14 14 $115 TPA

San Antonio, Texas $980+$980+

D*D**

ALLALL

XX

1818 X X X X X $845 14 14 $110 SAT

Santa Barbara, California X X X X X $1,450+ SD ALL X 18 $1,200 14 14 $245 $80

LAX SBA

Santa Monica, California X X X X X $1,160+ $1,540

DDQ

ALLALL

X 7

1818 $1,200 14 16 $160 LAX

Seattle, Washington GE X X X X X $1,390+ D ALL X 18 $1,010 14 16 $120 SEA

Silicon Valley, California X X X X X

$1,650+$1,650+$1,210+$1,450+$1,210+

S (HR)S (HH)D (HH)S (PC)D (PC)

ALLALLALLALLALL

XXXXX

1818181818

$1,355 14 16 $160 $120

SFO SJC

Thousand Oaks, California$1,975+$1,975+$1,975+

D**T**S*

ALLALLALL

141414

161616

X X X X X $1,100+ 14 14 $165 LAX

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Schedule A Schedule B – Housing and Airport Pick-up FeesB

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On-Campus Student Residence Off-Campus Student Residence Homestay

Atlanta, Georgia GE X X X X X $950+ DD ALL X 18 $1,000 14 16 $180 ATL

Boston – Downtown, Massachusetts GE, TEFL X X X X X $1,900+ $1,565+

S D

ALLALL

XX

1818 $1,210 14 16 $110 BOS

Bristol, Rhode Island X X X X X $1,800 D ALL 19 16 $1,110 14 14 $250 $140

BOS PVD

Charlotte, North Carolina GE X X X X X $790+ DD ALL X 18 $1,015 14 14 $90 CLT

Chicago, Illinois GE, BE $1,100 S ALL X 18 $1,600+$980+

SD DD

ALLALL

XX

1818 $1,170 14 16 $180

$155MDW ORD

Chicago – Romeoville, Illinois $895 D ALL $ 17 X X X X X $830 14 17 $150$140

MDW ORD

Columbus, Ohio (no bookings after Session 4 2017) $1,100+ D ALL $ 18 X X X X X $890 14 16 $75 CMH

Dallas, Texas $760 DD ALL X 18 X X X X X $970 14 16 $160 DFW

Grand Forks, North Dakota $980+ D ALL $ 18 X X X X X $775 14 18 $65 GFK

Hollywood, California X X X X X $770 $670

DT

ALLALL

XX

1818 $1,225 14 18 $160 LAX

Honolulu, Hawaii X X X X X$875

$1,730+$1,350+

S**SD

ALLALLALL

XXX

181818

$1,050 14 16 $90 HNL

Houston – Clear Lake, Texas $870 S ALL X 18 X X X X X $960 14 16 $220 $220

HOU IAH

Indianapolis, Indiana X X X X X $1,400 SD ALL X 18 $850 16 16 $125 IND

Johnson City, Tennessee $750 SD ALL X 18 X X X X X $850 14 16 $75 TRI

La Verne, California $950 D ALL X 17 X X X X X $980 14 14 $180 $180

LAX ONT

Lubbock, Texas $930 D ALL $ 17 X X X X X $950 14 14 $75 LBB

Miami, Florida GE $1,350+ D ALL 19 17 $1,280+ $1,070+

SDD

ALLALL

XX

1818 $1,010 14 17 $125

$135FLL MIA

Milwaukee, Wisconsin $790+ D ALL X 17 X X X X X $815 14 17 $25 MKE

Myrtle Beach, South Carolina $750 SD ALL X 18 X X X X X $840 14 17 $100 MYR

New York – Hofstra, New York $1,760+ D ALL $ 18 X X X X X $1,030 16 18$195 $110 $110

EWRJFKLGA

Oklahoma City, Oklahoma $640+ $800+

$1,100+

DS

SD

ALLALLALL

XXX

181818

X X X X X $785 14 16 $60 OKC

Philadelphia – Camden, New Jersey $1,130+ S ALL X 18 X X X X X $1,120 14 18 $135 PHL

Philadelphia – West Chester, Pennsylvania $1,050 D ALL 14 16 X X X X X $1,120 14 16 $145 PHL

Pittsburgh, Pennsylvania $835+ DD ALL X 18 X X X X X $860 14 15 $100 PIT

Portland, Oregon GE $1,100+ S ALL $ 18 X X X X X $900 14 14 $155 PDX

Ruston, Louisiana $655 D ALL $ 18 $655 SD** ALL X 18 $800 14 18 $180 MLU

San Diego, California GE X X X X X See recommended housing at www.ELS.edu/HousingRecommendations2017 $1,100 14 16 $85 SAN

San Francisco – Downtown, California GE X X X X X $1,150+ D ALL 7 18 $1,200 14 17 $95 SFO

San Francisco – North Bay, California GE X X X X X$780+$880+

$1,100+$1,380+

TD

DD*S

ALLALLALLALL

XXXX

18181818

$1,150 14 14 $150 SFO

San Jose, California X X X X X$2,625+$1,365+$945+

SDQ

ALLALLALL

XXX

181818

$1,350 14 16 $160$120

SFOSJC

Sioux Falls, South Dakota $780+ D ALL 7 17 X X X X X $820 14 17 $80 FSD

Tacoma, Washington CELTA X X X X X $780+ DD ALL X 18 $990 14 16 $170 SEA

Tampa, Florida X X X X X $2,500 S ALL X 18 $1,090 14 17 $85 TPA

Teaneck, New Jersey $1,300+ $1,390+

DD

AYSM

XX

1818 X X X X X $1,080 14 18

$135$210$210

EWRJFKLGA

Please note: Information is subject to change.X = Not applicableGE = Offers General EnglishBE = Offers Business EnglishiBT = Offers Complete Prep Program for the TOEFL iBT®CELTA = Offers CELTA CertificationTEFL = Offers TEFL Certification

* = Female only** = Male only+ = Additional deposit required – see Page 4 AY = Academic YearSM = Summer$ = Students receive a meal card with meal credits or pre-determined meal dollars

HR = Hanford Residence (Silicon Valley)HH = Hanford Home (Silicon Valley)PC = Park Circle Apartments (Silicon Valley)

TOEFL IBT®

Complete Prep Program for the TOEFL iBT® – 12-week coursestart date start date 1 January 2 8 July 174 March 27 11 October 9

TOEFL IBT®

Complete Prep Program for the TOEFL iBT® – 12-week coursestart date start date 1 January 9 8 July 244 April 3 11 October 16

M17-PD-ENG

4

Some student residence options require an additional key and/or damage deposit to be paid upon check-in for stays of any length. These fees are refunded to the student upon checkout if no damage or key loss is found, unless otherwise noted. The deposit amounts are as follows:

• Atlanta: $250

• Berkeley: $200

• Boston – Downtown: $200

• Charlotte: $200

• Chicago: $150 (River Forest Apartments)

• Cincinnati: $80

• Cleveland: $250

• Columbus: $200

• Denver: $200

• Fort Wayne: $150

• Grand Forks: $100

Student Residence Deposit Information

Should you need assistance with the application process, please contact a local ELS authorized Counseling Agent. For a complete list of counselors by country, visit ELS.edu/CounselorConnect.

The most important decisions require the best advice.

Central Admissions7 Roszel Road, Princeton, New Jersey 08540 U.S.A.Tel: +1.609.759.5900 • Fax: +1.609.524.9880 • E-mail: admissions@ELS.edu

TOEFL IBT®

Complete Prep Program for the TOEFL iBT® – 8-week and 4-week courses

start date start date start date start date start date start date1 January 9 3 March 6 5 May 1 8 July 24 10 September 18 12 November 132 February 6 4 April 3 6 May 29 9 August 21 11 October 16 13 December 11

Schedule A – Start Dates A

STANDARD PROGRAMS Intensive, Semi-Intensive, American Explorer and Business English start date start date start date start date start date start date start date1 January 9 3 March 6 5 May 1 7 June 26 9 August 21 11 October 16 13 December 112 February 6 4 April 3 6 May 29 8 July 24 10 September 18 12 November 13

TOEFL IBT®

Complete Prep Program for the TOEFL iBT® – 8-week and 4-week courses

start date start date start date start date start date start date 1 January 2 3 February 27 5 April 24 8 July 17 10 September 11 12 November 62 January 30 4 March 27 6 May 22 9 August 14 11 October 9 13 December 4

STANDARD PROGRAMS Intensive, Semi-Intensive, American Explorer and Business English start date start date start date start date start date start date start date1 January 2 3 February 27 5 April 24 7 June 19 9 August 14 11 October 9 13 December 42 January 30 4 March 27 6 May 22 8 July 17 10 September 11 12 November 6

Schedule B – Start Dates B

• Honolulu: $265 (Kalo Terrace; non-refundable)

• Houston (off-campus and host family): $200

• Kenosha: $50

• Melbourne: $75

• Miami (on-campus): $50

• Miami (off-campus): $75

• Milwaukee: $75

• Nashville: $100

• Oklahoma City: $150

• New York – Hofstra: $125

• Philadelphia: $100

• Philadelphia – Camden: $100

• Pittsburgh: $75

• Portland: $200

• Richmond – Kentucky: $50

• St. Louis: $150

• St. Petersburg (on-campus and host family): $200

• San Antonio: $65 (cash ONLY)

• San Francisco – Downtown: $275

• San Francisco – North Bay: $400

• San Jose: $300

• Santa Barbara: $150

• Santa Monica: $300

• Seattle : $200

• Silicon Valley: $300

• Sioux Falls: $100

• Tacoma: $100

• Teaneck: $100

• Thousand Oaks (on-campus and host family): $200