Rennert Fees and Dates 2012

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    www.rennert.com/english

    New York & Miami South Beach

    2012

    FEES &

    DATES

    2012

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    RENNERT: 2012 DATES AND FEES Prices in USD.

    American English ProgramIntensive communicative courses for adults 17 years and older

    NYC SoBe NYC SoBe NYC SoBe NYC SoBe

    Course Names Size Levels Hrs/wk 1-6 wks 7-11 wks 12-19 wks 20+ wks

    Vacation N Learn Max 10 1-10 16 hrs* 340 300 319 285

    Rapid Progress 20 Max 10 1-10 20 hrs* 340 300 319 285 295 275 272 255

    Rapid Progress 30 Max 10 1-10 30 hrs 420 385 394 375 375 355 319 300

    Business English Max 10 7+ 20 hrs* 340 300 319 285 295 275

    Electives Max 10 1-10 10 hrs 135 n/a 125

    *Options 4-10 wks 11-14 wksBusiness English in Action: add to any 20-hour American English Program 860 1110

    4 wks 5-8 wks

    Vacation and Volunteer: add to any Vacation N Learn program of 8 weeks or less 860 1110

    Start Dates

    All English students may start on any Monday.

    Beginners should begin on the first Monday of every month.

    Business English students must have an upper-intermediate level of English (Rennert level 7).

    Multi-Destination Combination Pricing

    New York and Miami (Minimum 2 weeks in one destination; must be booked at time of registration)

    2 weeks NYC + 2 weeks SoBe: 5% discount on English tuition

    4 weeks NYC + 4 weeks SoBe: 8% discount on English tuition

    6 weeks NYC + 6 weeks SoBe: 10% discount on English tuition

    For Combination bookings of 12+ weeks: 10% discount on English Tuition and free Registration Fee

    Exam Preparation Course Preparation for internationally recognized language tests

    NYC SoBe NYC SoBe NYC SoBe NYC SoBe

    Course Names Size Levels Hrs/wk 4-6 wks 7-11 wks 10 wks 12 wks

    TOEFL Success Max 10 5+ 20 hrs 340 300 319 285

    NYC TOEFL students may start any Monday. SoBe TOEFL programs start on the first Monday of the month.

    TOEFL course enrollment is a four-week minimum. Students must have an intermediate level of English.

    Students may register for the TOEFL exam at www.ets.org.

    TOEIC Preparation Max 10 5+ 30 hrs 420 n/a 394 n/a

    NYC TOEIC students may start any Monday. TOEIC Preparation can be added to RP 20 or chosen as an afternoon elective in RP 30. TOEIC exam is held on the last

    Friday of every month on-site, exam fee not included. Price includes RP 20 AM course.

    Cambridge CAE Max 12 8+ 28 hrs 3550 4500 4200

    NYC: CAE 12 week course: March 19 and September 10. CAE test dates are June 13 & December 5.

    SOBE: CAE 10 week course: January 2. CAE test is March 16 & 17.

    SOBE: CAE 12 week course: March 19, September 10. CAE test is June 13 & 15 and December 5 & 7.

    Cambridge FCE Max 12 7+ 28 hrs 3940 3550 4500 4200

    NYC: FCE 10 week course: January 2. FCE test date is March 9 & 10.

    NYC: FCE 12 week course: March 19 & September 10. FCE test dates are June 12 & December 4.

    SOBE: FCE 10 week course: January 2. FCE test is March 9 & 10.

    SOBE: FCE 12 week course: March 19, September 10. FCE test is June 16 & 17 and December 4 & 6.

    Cambridge BEC Vantage* Max 12 7+ 28 hrs 4500

    BEC 12 week course: March 12 & September 10. BEC test dates are June 7 & December 1.

    *Business English Program AM + BEC Preparation in PM, Monday-Thursday

    CAE/FCE/BEC students should arrange accommodations for post-course exam period.

    Academic Year Program Discounted pricing for long-term students

    NYC SoBe NYC SoBe NYC SoBe NYC SoBe

    Course Size Levels Hrs/wk 24 wks 36 wks 48 wks

    Academic Year Max 10 1-10 30 hrs 309 290 299 280 289 270

    Max 10 1-10 20 hrs 265 250 255 240 245 230

    12 wks

    University Access Max 12 7+ 30 hrs 395

    Start Dates

    Academic Year start dates: Any Monday.

    University Access Start dates: May 14 and September 17.

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    Professional English Program Intensive programs for the experienced professional

    NYC SoBe NYC SoBe

    Course Size Hours 1 - 5 wks 6+ wks

    Part-Time Professional Group Max 5 15 hrs/wk 635 555 565 520

    Full-Time Professional Group Max 5 30 hrs/wk 1005 870 880 805

    Professional Combination (group+private) Max 5 (1-on-1) 30 hrs/wk (15/15) 1978 1725 1730 1590

    Part-Time Professional Private 1-on-1 15 hrs/wk 1368 1195 1245 1150

    Full-Time Professional Private 1-on-1 30 hrs/wk 2705 2360 2450 2255

    Full-Time Professional Private w/Excursions 1-on-1 30 hrs/wk 2895 2525 n/a n/a

    Advanced Conversation and Writing Elective Max 5 8 hrs/wk 430 n/a 390 n/aProfessional English for Specific Purposes

    Finance Max 5 15 hrs/wk 810 n/a n/a n/a

    Sales/Marketing Max 5 15 hrs/wk 810 n/a n/a n/a

    Law Max 5 15 hrs/wk 810 n/a n/a n/a

    Accent Reduction 1-on-1 10 hrs min 160/hr 125/hr 160/hr 125/hr

    Private Lessons 1-on-1 5 hrs min 100/hr 88/hr 95/hr 78/hr

    International Networking Meetings 1-on-1 4-6 hrs/wk 580 n/a 580 n/a

    E-mail Follow-up Course (3 months) 1-on-1 18 emails 405 380 405 380

    Skype or Phone Follow-up Course (3 months) 1-on-1 12 30-minute lessons 405 380 405 380

    Start Dates: Professional students must have an intermediate level to join this program.

    NYC Professional students may start any Monday.

    SoBe start dates are the first Monday of the month, except in summer with start dates every Monday from July 2 to August 27.

    English for Specific Purposes courses require an upper-intermediate to advanced level of English and are offered on the dates below:Finance (1 week) April 16 May 7 July 16 Aug 6 Sept 17

    Sales and Marketing (1 week) April 23 May 14 July 23 Aug 13 Sept 24

    Law (1 week) April 30 May 21 July 30 Aug 20 Oct 1

    Arts plus English Programs

    Course Term Cost Start Dates

    BodiBalance Dance 4 weeks 860 June 11, July 9

    Steps On Broadway 2 week minimum 112/wk Any Monday

    Fashion Intensive 4 weeks 1350 March 19, July 9, August 6

    Fashion Saturdays 7 weeks 300 January 30; Inquire about other dates

    Music: Private Lessons 2 week minimum 165/wk Any Monday

    Music: Intro to Jazz 14 weeks 255 February 20; Inquire about other datesMusic: Jazz Piano Workshop 14 weeks 400 February 20; Inquire about other dates

    Make-Up Artistry 9 weeks 885/50 hrs January 9, March 19, June 4, September 10

    Photography 1 Digital (includes a free class in Mac Basics) 7 weeks 845 July 2; Inquire about other dates

    Photography: B & W Camera and Darkroom 4 weeks 795 July 9; Inquire about other dates

    Photography: Travelling in New York

    (intermediate level photography)4 weeks 495 July 9; Inquire about other dates

    Photographing Musicians (intermediate level photography;

    must submit jpgs of your work)5 weeks 545 July 2; Inquire about other dates

    Culinary: Essentials of Fine Cooking 4 weeks/40 hrs 2650 August 6, September 10, November 26

    Culinary: Chocolate Desserts 2 weeks/15 hours 785 July 9, September 17, November 12

    Culinary: Parisian Breads 1 week/12 hours 675 February 20, April 23, July 16

    Super-Intensive Film or Digital Filmmaking

    4 weeks of English; 4 weeks Filmmaking

    English course fees not included.

    8 weeks total 3310

    January 9, February 6, March 5, April 9,

    May 7, June 11, July 9, August 13, Tuesday,

    September 4, October 8

    Filmmaking Materials Fee 500

    Super-Intensive Acting 4 weeks of English, 4 weeks Acting. English

    course fees not included. Acting students must have an advanced level

    of English.

    8 weeks total 3650

    January 9, February 6, March 5, April 9,

    May 7, June 11 July 9, August 13, Tuesday,

    September 4, October 8

    SoBe Jewelry Making*

    Additional Materials Fee of $25 + tax applies6 weeks 220

    January 9, March 5, April 30, June 25,

    Tuesday, September 4, October 29

    SoBe Photography Black and White Course*

    Additional $40 + tax/lab fee or $25 + tax/materials fee may apply.6 weeks 220

    January 9, March 5, April 30, June 25,

    Tuesday, September 4, October 29

    SoBe Salsa/Latin Dance 30/wk Any Monday

    * Minimum enrollment required for some SoBe Art plus programs

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    TESOL Teacher TrainingInternationally recognized teacher training certificate programsNew York City only. Students must have an upper-intermediate level of English and successfully complete the application process.

    Course Size Hours of Course Term Price

    SIT Best Practices in TESOL Certificate Max 10 210 6 wks 3350

    Start Dates: January 30, March 19, May 7, July 2, September 10, October 29

    Rennert TESOL Certificate Max 12 120 4 wks 2430

    Start Dates: January 2, August 6, November 26

    Teaching English to Young Learners Certificate (TEYL) Max 10 30 1 wk 495

    Begins after the SIT Best Practices in TESOL course

    Start Dates: March 12, April 30, June 18, August 13, October 22, December 10

    plus 2-week Practicum Intensive

    plus 1-week Practicum Intensive (Dec only)

    Max 10

    Max 10

    60

    30

    2 wks

    1 wk

    1000

    500

    Begins after Teaching Young Learners course (TEYL).

    Start Dates: March 19, May 7, June 25, August 20, October 29, December 17 (one-week course)

    Total TESOL Package Max 10 420 13 wks 6190

    4 weeks of English, followed by SIT Best Practices in TESOL program, Practicum Intensive and TEYL Certificate.

    Start Dates: January 2, Tuesday, February 21, April 9, June 4, August 13, October 1

    English Improvement RP30 Max 10 120 4 wks 1680

    Course begins 4 weeks prior to SIT Best Practices in TESOL or Rennert TESOL course.

    Start Dates: SIT Course: January 2, Tuesday, February 21, April 9, June 4, August 13, October 1

    Start Dates: Rennert Course: November 28, 2011, July 9, October 29

    Teaching Business English Certificate (TBE) Max 10 30 1 wk 495

    Begins after the Rennert TESOL course in January and September and after the SIT Best Practices in TESOL course in April.

    Start Dates: January 30, April 30, Tuesday, September 4

    plus TKT Preparation and Test Max 10 30 1 wk 495

    Begins after the Rennert TESOL course. Test takes place after Preparation course ends.

    Start Dates: Inquire for dates

    2012 NEW YORK CITY ACCOMMODATIONS

    MEAL PLANS Breakfast Lunch

    Meals are NOT included in Rennert accommodations, however meal plans may be purchased in the form of meal tickets.

    Meal tickets may be redeemed for food Monday to Friday at local eateries close to all Rennert locations.

    Tickets are non-refundable

    20/wk 40/wk

    HOMESTAY PROGRAM Single Double

    Manhattan - Minimum stay is 2 weeks

    Single with Breakfast 7 days (provided Monday to Sunday)

    + Dinner 5 days

    490/wk

    +85/wk

    n/a

    n/a

    Queens/Brooklyn - Minimum stay is 2 weeks

    with Breakfast 7 days (provided Monday to Sunday)

    + Dinner 5 days

    + Dinner 7 days

    340/wk

    +58/wk

    +85/wk

    225/wk per person

    +58/wk per person

    +85/wk per person

    RESIDENCE HALLS Single Double

    Economy Residence: Vanderbilt YMCA/West Side Y

    Maximum stay is 90 days.

    Doubles are for two students arriving together.

    450/wk 350/wk per person

    Standard Residence: De Hirsch Residence 92nd Street Y - Minimum stay is 28 days

    Rates include use of the library, gym, and internet access where available.

    469/wk 395/wk per person

    Brandon Residence for Women

    Rates include breakfast and dinner at a dining facility in the building.

    395/wk n/a

    1760 Residence

    Double rooms with private bathrooms in modern, newly-renovated residence.

    Located on Upper East Side of Manhattan, short distance from school by public transportation.

    n/a 395/wk

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    2012 SoBe ACCOMMODATIONSS

    MEAL PLANS Breakfast Lunch

    Meals are NOT included in Rennert accommodations n/a n/a

    HOMESTAY PROGRAM Single Double

    Single with Breakfast 7 days (provided Monday through Sunday)

    + Dinner 7 days

    Minimum stay is 2 weeks

    325/wk

    +75/wk

    n/a

    n/a

    Hotels Single Double

    Clay Hotel Single and Double rooms, private bathrooms and kitchenette for light cooking.

    465/wk 265/wk per person

    Apartments

    South Beach Studios

    Private bathrooms and kitchen facilities in private studio apartment.

    435/wk n/a

    South Beach Executive ApartHotel

    Single and double rooms in fully-furnished and equipped apartments.

    525/wk 375/wk per person

    Rates include 13% hotel tax.

    Students must be at least 18 years old to stay in apartments.

    Apartments require a refundable $300 security deposit.

    Students arrive on a Sunday and depart on a Saturday.

    Weekly rate surcharge may apply during holiday periods.

    FEES, POLICIES AND HOLIDAYSRegistration and Program Fees

    Registration 155 Non-refundable and due when registration is sent.

    Study Materials 69 Includes first set of books, unlimited broadband access, WIFI, and student identification card.

    The Arts plus Registration 110 Additional non-refundable registration fee for all Arts plus English courses.

    Express Delivery 80 Optional rush mail fee for I-20s and other forms.

    NYC Cambridge Exam 405 FCE, CAE and BEC V exam fee. Exam takes place after course completion.

    SoBe Cambridge Exam 265 FCE and CAE Exam Fee. Exam takes place after course completion.

    TOEIC Exam (NYC only) 85 TOEIC exam fee. Offered the last Friday of every month.

    Program Change 60 Administrative fee for program changes requested after course begins.

    Airport Transfer Manhattan 159 Optional one-way transfer to or from Manhattan to Newark, LaGuardia, JFK airports.

    Airport Transfer Brooklyn/Queens 195 Optional one-way transfer to or from Brooklyn/Queens to Newark, LaGuardia, JFK airports.

    Airport Transfer Miami 125 Optional one-way transfer to or from MIA Airport to or from Miami area.

    Airport Transfer Ft Lauderdale 160 Optional one-way transfer to or from Ft. Lauderdale Airport to or from Miami area.

    Health & Travel Insurance 60 Non-refundable Guard.me health and travel insurance.

    Price includes coverage for 30 days. For + 30 days, additional $2 per day.

    Accommodation Fees

    Accommodations 85 Non-refundable placement fee for all accommodation bookings

    Room Change 85 Applies to residence halls and apartments

    Additional night (Single) 90 Applies to all accommodations

    Additional night (Double) 80 Applies to all accommodations

    Maximum of 1 additional night in apartments. Students may be charged additional cleaning fees. Three additional nights or more will be billed as one full week.

    MANHATTAN APARTMENTS Single Double

    Upper Manhattan East Apartments - Minimum stay is 14 days

    Single and Double rooms in two-bedroom, fully-equipped and funshished

    apartments. Apartments shared with other Rennert students of mixed gender.

    480/wk 385/wk per person

    Midtown East Apartments - Minimum stay is 14 days

    Single rooms only.

    Apartments shared with other Rennert students of mixed gender.

    Jan 1-May 28 May 29-Nov 26 Nov 27-Dec 31

    575/wk 600/wk 575/wk

    Midtown Studios - Minimum stay is one month 3600/month 3900/month 3700/month

    All apartments require a refundable $300 security deposit, paid at school upon arrival. Students must be at least 18 years old to stay in apartments.

    Students must arrive on a Sunday and depart on a Saturday.

    Students staying additional nights in apartments may be charged additional cleaning fees.

    New York City Accommodations Continued....

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    Program Terms and Conditions

    Students participating in English programs at Rennert must be at least 17 years of age and non-native speakers of English.

    Students will be assigned to afternoon or morning schedules based on level and availability.

    There are no guaranteed morning classes.

    Prices and policies are subject to change with approval of the New York State Education Department.

    The binding version of the registration package can be found at www.rennert.com.

    This school is authorized under federal law to enroll non-immigrant alien students. Csar Rennert is a certified sales agent for Rennert. He is registered

    with the New York State Education Department, Bureau of Proprietary Supervision and his sales license number is #11552508.

    Cancellation PoliciesPrior to Start Date

    All registrations must be paid in full at least 10 business days prior to arrival or the registration will be cancelled.

    All program cancellations received in writing at least 10 business days prior to program start date are eligible for a full monetary refund.

    The Registration Fee is non-refundable if courses are cancelled at any time, but may be applied to future registrations in the same calendar year.

    Rennert will make refunds only to the person or agency that paid the school.

    If cancellation is received fewer than 10 business days prior to start date, or if the student fails to arrive on the start date, tuition is not monetarily

    refundable but tuition credit may be applied.

    Tuition credit is valid for one calendar year.

    After Classes Begin

    No monetary refunds will be made for program cancellations, but tuition credit may be applied.

    Program cancellations must be given 4 weeks prior to departure date.

    Once 4 weeks notice is given, tuition credit will be issued to the person or agency that paid the school.

    Tuition credit is valid for one year from the date of cancellation and cannot be transferred to another student.

    Tuition credit is for classes only and cannot be applied towards books or fees nor can group class credit be applied towards private class credit.

    Program changes require 4 weeks notice and are subject to a $60 program change fee.

    There are no program changes or program credits given on registrations of 4 weeks or less.

    Accommodations Terms and Conditions

    Rennert is not responsible for personal belongings or student legal guardianship.

    There is no smoking or alcohol usage permitted in Rennert housing facilities.

    Students who violate this code will be ejected immediately without refund. Rennert students are expected to conduct themselves as responsible adults.

    Students arrive the Sunday before classes begin and depart the Saturday after classes finish.

    Accommodations are only available to Rennert students during their period of study.

    Overnight guests are not permitted.

    Rennert cannot guarantee availability in first choice of accommodations.

    Prices are subject to change due to availability.

    Reservations cannot be confirmed until a Rules Acknowledgment Form is signed and returned.

    Accommodations Cancellation Policy

    Prior to Arrival

    All reservations must be paid in full at least 10 business days prior to arrival or reservations will be released.

    Accommodations cancellations must be received in writing 10 business days prior to arrival.

    If cancellation is received with 10 business days notice, the accommodations fee will be fully refunded with the exception of the non-refundable

    accommodations placement fee.

    If proper notice is not received or the student does not arrive on the reserved date, the first 2 weeks of the accommodations fee in addition to the

    accommodations placement fee is non-refundable.

    After Arrival

    Accommodations cancellations must be given 4 weeks prior to departure date.

    Once 4 weeks notice is given, a monetary refund will be provided to the person or agency that paid the school.

    Accommodations changes require 4 weeks notice and are subject to an $85 room change fee.

    There are no refunds, cancellations or changes for reservations of 4 weeks or less.

    Holidays

    All locations will be closed from Monday, December 24, 2012 to Friday, December 28, 2012.

    All locations will reopen on Monday, December 31, 2012 and will be closed Tuesday, January 1, 2013.

    All locations will be closed on the following holidays, for which there is no compensation for group instruction hours lost:

    Monday, February 20 Presidents Day Monday, May 28 Memorial Day Wednesday, July 4 Independence Day

    Monday, September 3 Labor Day Thursday and Friday, November 22 & 23 Thanksgiving

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    Registration Form 2012Psal Ifmai

    FAMILYNAME GIVENNAME

    CuNtrYFBIrth CItIzENshIp DAtEFBIrth:DAY/MNth/YEAr NAtIVELANGuAGE

    EMErGENCYCNtACtNAME CuNtrYCDE/tELEphNE EMAIL

    Addss: Hm Cuy

    strEEtADDrEss CItY pstALCDE CuNtrY

    tELEphNE FAx EMAIL

    Addss: US

    strEEtADDrEss CItY pstALCDE CuNtrY

    tELEphNE FAx EMAIL

    Cus Ifmai

    DeStInAtIon: NYC sBE CombinaionNY/soBepogam

    StArt DAte:Day:________Mon:________Yea:________toalnmbeofweek ________ For Combination Programs:Nmbeofweek:NYC______+soBe_____

    LeveL o engLISH: Beginne Inemediae Advanced

    Ha yu sudid a r bf? No Ye Wen?Day:_______Mon:_______Yea:_______Wiclocaion? NewYok Miami

    Hw I had abu r: Agency Webie Fiend Magaine e________________________________________

    Pam Slci

    American English Program WeeksVacaionNLean ________

    raidpoge20 ________

    raidpoge30 ________

    BineEngli ________

    Elecive ________

    BineEngliinAcion ________

    VacaionandVolnee ________

    Exam Preparation Courses Weeks

    tEFLscce ________

    tEICpeaaion ________

    CambidgeCAE ________CambidgeFCE ________

    CambidgeBECVanage ________

    Academic Year Program Weeks

    AcademicYea ________

    univeiyAcce ________

    TESOL Teacher Training WeekssItBepaciceintEsLCeificae ________

    rennetEsLCeificae ________

    teacingEnglioYongLeane ________

    +pacicmInenive ________

    toaltEsLackage ________

    EngliImovemenrp30 ________

    +tEYLCeificae ________

    +teacingBineEngliCeificae ________

    +tKtpeaaionandte ________

    Professional English Program Weeks

    pa-timepofeionalGo ________Fll-timepofeionalGo ________

    pofeionalCombinaion ________

    pa-timepofeionalpivae ________

    Fll-timepofeionalpivae ________

    FtpofpivaewiEcion ________

    EnglifoLaw,sale, Finance* ________

    AdvancedConveaionElecive ________

    Accenredcion ________

    pivaeolyleon ________

    InenaionalNewoking ________

    E-mailFollow-Coe ________

    skyeoponeFollow-Coe ________

    The Arts plus English WeeksBodiBalancetMDance ________

    seonBoadwayDance ________

    FaionInenive ________

    Faionsaday ________

    Mic:pivae ________

    Mic:InooJa ________

    Mic:Japiano ________

    Make-Aiy ________

    poogay1Digial ________

    poogay:B&W ________

    poogay:tavellinginNewYok ________

    poogaingMician ________Clinay:EenialofFineCooking ________

    Clinay:CocolaeDee ________

    Clinay:paiianBead ________

    FilmmakingoAcingInenive* ________

    soBeJewelyMaking ________

    soBepoogay:Black&Wie ________

    soBesalaLainDance ________

    Alcoefeeaeinaddiion

    oEnglicoefee

    *Please circle one choice

    MALE FEMALE

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    Accmmdais

    Ye No(Anon-efndableAccommodaionFeeof$85alieandmbeincldedwiyoegiaion.)

    Accommodations Start date:Day________Mon_______Yea______End Date:Day________Mon_______Yea______

    *A 2-week housing deposit must be received to hold your reservation.

    All accommodations begin on Sunday and end on Saturday

    IsuacYe,IwillcaerenneGad.Mehealandtavelinance.

    No,Iavemyownealandavelinanceandwilloviderennewioofonaival.

    Aip Pickup

    Aival Aival&Deae NoPlease provide us with travel information at least two weeks before arrival

    Cs Wksh

    regiaionFee: $155

    sdyMaeialFee: $69

    tiionCo _________

    Altiionco _________

    AlregiaionFee:$110 _________

    AccommodaionCo _________Accommodaionplacemen

    (non-efndable):$85 _________

    tEICEamFee:$85 _________

    CambidgeEamFee

    (NYC:$405;soBe:$265) _________

    ionalAiotanfe

    Manaan(eacway):$159 _________

    Booklyn/Qeen(eacway):$195 _________

    Miami(eacway):$125 _________

    F.Ladedale(eacway)$160

    ionalEeDelivey:$80 _________

    Gad.MehealandtavelInance

    $60.($2/dayfo30+day) _________

    totAL _________

    Mhd f Paym

    neW Yor

    International Money Order Bank Wire Transfer to Rennert New York,Accon#752181115,

    JpMoganCaeBank,1uniedNaionplaa,NY10017-0431swifCodeChAsus33roing#/ABA

    [email protected]

    SoUtH BeACH

    International Money Order Bank Wire Transfer to: Rennert South Beach ,Accon#

    2000059173135,WellFagoBank,N.A.,757tidAve.,NewYok,NY10017,usA;swifCodepNBpus33,

    roing#/ABA026012881.Nocageobeneficiay.pleaenoifybyemailwenyoiniiaeany

    wieaymen.

    Cdi Cad Paym Via MaeCad AmeicanEe

    CArDNuMBEr: ExpIrAtINDAtE:MNth/YEAr

    Ieebyaoierenneocagemycedicadineamonofu.s.D._________________.

    NAMEFCArDhLDEr

    sIGNAturEFCArDhLDEr DAtE

    Yu Am - Your signature is required to complete your registration

    Iaveeadandndeoodeemolinedinrenneliofiionandaccommodaionae,co,condiion,cancellaionolicie,andFomI-20eqeinfoma-

    ion.IavealoeadandndeooddeciionofecoefowicIamegieing,andalloedicloemaeial.IaffimaIavefficienfndoayall

    iionandecooffood,accommodaionandeonaleenedingmyeiodofdyarenne.Iaoierenneoakeaoiaemedicalacionincae

    ofillneoinjy,andIndeandaIameoniblefoallmedicaleene.IaffimaIknowaallF-1denmbecoveedbyvalidaveleinancefo

    edaionofeiay.IceifyaeinfomaiongivenbymeiniregiaionFomiaccaeandcomlee.

    sIGNAturEFstuDENt sIGNAturEFspNsr(Ifdeninde18yeaold)DAtE

    Homestay* Single Double

    Manaan

    +dinne5day

    Booklyn/Qeen

    +dinne5day

    +dinne7day

    If requesting a double room, please

    list the person you will share with:

    __________________________________

    Residence Single Double

    Dehic92ndsY

    VandebilYMCA

    Bandon(foWomen)

    1760reidence

    Apartments

    ueManaanEa

    Midown

    Midownsdio

    Please list second choice:

    __________________________________

    Homestay* Single Double

    homeay

    +dinne7day

    Residence/Hotel

    Clayhoel

    Apartments

    soBeacsdio

    soBeacAahoel

    *If your choices include Homestay,

    please answer the following:

    Doyomoke? Ye No

    Can you live in the same household

    as a pet? Ye No

    Do you have any allergies? If yes,

    please list:________________________

    ___________________________________

    Can you live in the same household

    as young children? Ye No

    Special requests____________________

    ___________________________________

    ___________________________________

    Sud visa

    WillyoneedafomI-20? Ye No Aeyoaanfeden? Ye No

    DoyowanyoI-20iedbyeemail?($80eemailfeealie) Ye No

    neW Yor SoUtH BeACHNYC Meal Tickets: Beakfa Lnc