OKLAHOMA STATE UNIVERSITY

APPLICATIONENGLISH LANGUAGE INSTITUTE

BEFORE MAILING: Please be sure you have: 1. 2. 3. 4. 5. I would like to attend the OSU English Language Institute beginning: Full Legal Name
(as it appears on your passport) Family or Last Given or First Middle

(1) answered all questions completely (2) enclosed $50 application/processing fee Spring, January 20_____

(3) attached required financial guarantee (4) signed and dated this application Fall, August 20_____

Summer, June 20_____

Nickname
(if applicable)

U.S. Social Security Number

(if applicable)

Other names under which your records may appear

(if applicable)

Family or Last

Given or First

Middle

6.

Date of Birth
Month

/
Day

/
Year

Place of Birth
City State Province Country

7.
8.

Gender
Citizenship/Residency

Male

Female

Marital Status
(optional)

Single

Married

Are you a United States Permanent Resident Alien? Country of citizenship Do you currently hold non-immigrant status?

Yes No Native Language No If yes, indicate type

Yes

If yes, submit a copy of your passport, US visa, I-94 card and appropriate CIS document (I-20, DS-2019, etc.)

If you currently hold non-immigrant status, do you intend to apply for a change of visa status? Yes No If yes, visa type: If you are not currently in the U.S., what type of visa do you plan to use when entering the U.S.?

F-1
9. E-Mail Addresses

J-1

Other

Preference 1 Preference 2 Please print clearly. Your E-Mail addresses will be used to correspond with you prior to admission.

10. Current Address/Phone

All OSU correspondence prior to beginning of classes will be mailed here. Address Line 1 Address Line 2 City State Include Country and City or Area Code Zip Country

Phone: 11. Permanent (Home Country) Address/Phone

If you are currently residing in the U.S., you must provide your permanent address outside of the United States.

Fax:
Include Country and City or Area Code

Address Line 1 Address Line 2 City State Include Country and City or Area Code Zip Country

Phone:

Fax:
Include Country and City or Area Code

Continued on back
Revised 10/2008

12. Parent, Legal Guardian or Next of Kin

Family or Last

Given or First

Middle

Relationship: 13. Previous Application

Father

Mother

Other (please specify)

Yes No Have you previously applied to ELI and/or OSU? If yes, list semester of application: and, if applicable, OSU ID Number: Do you plan to enter OSU after completing English? Yes If yes, please check degree sought: Bachelors Masters Doctorate/PhD Field of study: No

14. English Language Training

Are you currently enrolled in or do you plan to enroll in a U.S. English language program other than the OSU English Language Institute? Yes No If yes, list school name,
Institution Name

address, and
Institution Address

enrollment dates
Date entered Date completed or anticipated completion date

15. U.S. Education

Are you currently attending an educational institute in the U.S.? If yes, list the name and address:

Yes

No

16. Application Fee

I have enclosed the non-refundable $50.00 application/processing fee required of all applicants. Please make checks payable to OSU. (Checks, money orders, or bank drafts are acceptable forms of payment.) DO NOT SEND CASH. Credit cards cannot be accepted as payment.

17.

Express Mail Service

If you are admitted to OSU ELI, you have the option of having your admission documents sent to you via express mail. The cost to express mail to overseas locations varies from $25.00 to $65.00 US dollars. The exact cost can be provided if you contact the office processing your application. The credit card listed below will not be charged until the office processing your application is ready to mail the admission package. I am requesting that the express mail charges be charged to the credit card identified in Item #18 below.

18. FOR EXPRESS MAIL REQUESTS ONLY ... Credit Card Charge Authorization: If a second party credit card is being used, a copy of the front and back of the card must be included before the charge can be processed. Credit card type: Mastercard VISA For EXPRESS MAIL requests, provide complete address: Card number: Expiration date on card: Name on the card: Cardholders signature:
Telephone number of recipient:

19. Applicants Signature

Date:

Please review your application carefully to determine that all information is complete. An incomplete application or failure to submit a complete financial guarantee will result in a delay in processing. Submit completed ELI application, financial guarantee form, and $50.00 application fee to the following address: Director, English Language Institute Phone: (405) 744-7519 Oklahoma State University Fax: (405) 744-7520 307 Wes Watkins Center E-Mail: osu-eli@okstate.edu Stillwater, OK 74078-8087
Revised 10/2008