PERSONAL INFORMATION

First name:
Middle name:
Last name:
Gender: Male Female
Address:
City:
State:
Province:
Country:
Postal code:
Telephone number:
Email:
Date of birth: mo day year
Country of birth:
Country of citizenship:
Please rate your English ability: Low
Intermediate
High
How did you learn about TLC?

EMERGENCY CONTACT

Emergency Contact Name:
Contact's Email Address:
Contact's Phone Number:
Relationship to Applicant:

PROGRAM INFORMATION

Choice of TLC Center for study:
Choice of Program:
In which session will you begin your studies?
2018:
2019:
How many sessions will you study?

HOUSING INFORMATION

TLC can arrange several different types of housing for you. A housing placement fee may apply.
Do you want TLC to help you find housing? Yes, I want TLC to help me find housing (a fee may apply).
No, I will find my own housing.

ADDITIONAL SERVICES

Airport Pickup Service (Click here for price list): Pickup
Pickup and Return
No
Would you like TLC to provide health insurance for you? Yes No

ACADEMIC GOALS

Will you attend a university in the United States? Yes No
If yes, where?
Will you attend a high school in the United States? Yes No
If yes, where?
Would you like TLC to help you apply? Yes No

VISA INFORMATION

Do you currently hold a valid U.S. student visa (F-1)? Yes No
Do you need an I-20 Form? Yes No
Are you transferring from another school? Yes No
If yes, please tell us the name of the school you are currently attending:
Will any dependents be traveling to U.S. with you? Yes No
If so, please list the legal names of all dependents traveling with you, date of birth, country of birth, country of citizenship, and their relationship to you.

ACCEPTANCE PACKET

How do you want to receive the acceptance packet? I will pick it up in person.
Mail it to me.