The American English and Culture Program 4-Week Application

The American English and Culture Program
4-Week Application
NAME
(family/last)
as written
on passport
ADDRESS IN HOME COUNTRY (P.O. Box permitted)
(given/first)
(middle)
CITY / COUNTRY / POSTAL CODE
COUNTRY OF CITIZENSHIP
COUNTRY OF BIRTH
TELEPHONE
BIRTHDATE GENDER SESSION START DATES (See calendar on back of application)
(month / day / year) Male 4/9/13 - 5/7/13 8/19/13 - 9/16/13
11/7/13 - 12/10/13
5/17/13 - 6/18/13 9/16/13 - 10/11/13 1/8/14 - 2/5/14
Female
6/14/13 - 7/15/13 10/11/13 - 11/7/13 2/5/14 - 3/4/14
DO YOU WANT TO TRANSFER FROM ANOTHER SCHOOL Yes No
If yes, include your current US address and an AECP transfer form (http://global.asu.edu/aecp/apply#Transfer) completed
by your current US school advisor.
IN WHAT COUNTRY WILL YOU APPLY FOR YOUR STUDENT VISA
FAX
STUDENT’S EMAIL
WILL SPOUSE AND/OR CHILDREN ACCOMPANY YOU
DEPENDENT NAME
DEPENDENT NAME
COUNTRY OF CITIZENSHIP
COUNTRY OF CITIZENSHIP
Yes
No
COUNTRY OF BIRTH
COUNTRY OF BIRTH
If yes, complete the information below for your spouse and each child. If more
lines are needed, attach a separate page with the additional information.
BIRTHDATE
(month/day/year)
BIRTHDATE
(month/day/year)
RELATION
Spouse
Child
RELATION
Spouse
Child
GENDER
Male
Female
GENDER
Male
Female
$105 APPLICATION PAYMENT METHOD (includes application fee and express mail fee):
(month / year)
Money Order enclosed
Credit Card (Visa, Mastercard, Discover): # Exp. /
AFTER STUDYING AT AECP, WILL YOU STUDY AT ASU Yes No PLEASE TELL US WHERE YOU LEARNED ABOUT AECP
If yes: Undergraduate Graduate
Past or present AECP student
Friend or relative in the US
Intended major: ________________________________________
Internet Education fair Advertisement
If no, what will you do Return home
Agent ____________________ Agent Email________________________
Other: _____________________________
---------------------------------------Please cut and send upper portion to AECP. Retain lower portion for your records---------------------------------------
4-Week Session Program Costs
(2012 - 2013)
Tuition.......................................................$1575
Student Services Fee...................................$112
Total...........................................................$1687
Additional 4-Week Costs
On-Campus Dormitory (estimated)...............$800
or
Homestay (includes 2 meals per day).........................$660
Medical Insurance (cost varies each session)..............$77
Books and Supplies (estimated).........................$190
ASU ID Card (one-time fee).................................$25
Personal Expenses (variable, estimated)..................$200
Tuition, program fees, and medical insurance must be
paid in full at the beginning of the term. Plan to arrive
with cash, traveler’s checks, or a Mastercard, American
Express, or Discover card.
To pay the $105 non-refundable fee for application
and express mail, include your credit card number and
expiration date above, or prepare a money order (USD)
payable to Arizona State University.
Email, fax, and/or mail application, financial guarantee,
and payment to:
Email:
Fax:
Mail:
Phone:
aecp@asu.edu
480-965-8529
American English and Culture Program
P.O. Box 873504
Arizona State University
Tempe, Arizona 85287-3504 U.S.A.
480-965-2376
If you have questions, please contact us:
http://global.asu.edu/aecp
This information is based on information available as of July 2011 and is subject
to change without notice. Arizona State University vigorously pursues equal
opportunity and affirmative action in its employment, activities, and programs.
By submitting this application you give permission to AECP to contact you with
information regarding AECP.

American English & Culture Program
P.O. Box 873504
Tempe, AZ 85287-3504 U.S.A.
BANK GUARANTEE
International students are required to certify that they have adequate resources to pay for the cost of tuition, fees, and
living expenses while enrolled in the American English and Culture Program. A minimum of $5000 is required.
Please indicate the source and amount of funds available (in U.S. dollars).
Source:
r r r r
Amount:
Date:
Personal Family Sponsor* Other
Bank Verification (official stamp required)
I certify that the above information is a true and accurate statement of my finanacial resources and that these funds are
available to pay for the program at AECP.
Name of Student (please print):____________________________________________________________
Signature of Student: ___________________________________________________________________
* If sponsor is an organization and wishes to be billed directly for the program, AECP must recieve a letter of financial
guarantee with billing instructions before an I-20 will be issued.
AECP Session Dates
Summer:
Fall:
2013 2014
May 17 - June 18
June 14 - July 15
August 19 - September 16
September 16 - October 11
October 11 - November 7
November 7 - December 10
Spring:
Summer:
January 8 - February 5
February 5 - March 4
March 12 - April 8
April 8 - May 6
May 14 - June 11
June 11 - July 10
Please apply at least one month before your session begins.
For more information about AECP, visit: global.asu.edu/aecp/calendars