Student Application

Personal Information

*First Name
Middle Name
*Last Name
*Gender
*Home Address
*City
*State
*Postal Code
*Country
Phone
*Email Address
*Birth Date
*Birth Country
*Citizenship Country
*How do you rate your English ability?
*How did you find out about TLC?
Details (please specify):

Emergency Contact

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