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Application form ilsc san francisco 2010
1. ILSC San FranCISCo
2009/2010 application for admission
S T U D E N T I N F O R M AT I O N
Family Name(s): First Name: Full Middle Name(s):
(as shown on passport) (as shown on passport) (as shown on passport)
Gender Male Female Birthday (mm/dd/yy): ________ / ________ / ________ Country of Birth:
Nationality: First Language:
Address in Home Country (Home/Apt #, Street): City:
Province/State: Country: Postal Code:
Tel: Cell: Email:
Mailing Address (if different from Address in Home Country): City:
Province/State: Country: Postal Code:
Emergency Contact Name: Emergency Tel:
S T U DY I N F O R M AT I O N
Full-Time Intensive (28 lessons/wk) Full-Time (20 lessons / wk) Semi Full-Time (16 lessons / wk)
Programs: General English English in Action English on the Road West Coast Connection Other
Start Date (mm/dd/yy): _______ /_______ / _______ Weeks of Study:
I first found ILSC through: Friend / Family ILSC website Other website Search Engine (Google / Yahoo) / other
Agency (Agency Name / Fax): /
Status in U.S.: Student Visitor Other
Do you need an I-20* to apply for a student visa? Yes No
If yes, do you require documents to be sent via Express Mail (non-refundable $50) Yes No * ILSC CAnnoT ISSUe I-20’s UnTIL We HAve
Do you already have a valid U.S. student visa and are transferring from another institution? Yes No Been APPRoveD By SevIS. We exPeCT
THIS To oCCUR By JUne 2010.
If yes, please write the name of the institution:
A C C O M M O D A T I O N I N F O R M A T I O N ( i f a pplica ble)
Homestay Room (Choose one) Single Shared Bathroom (Choose one) Private Shared
Student Residence Room (Choose one) Single Shared Meals per Day (Choose one) 2 meals Breakfast Only
Alternative Accommodation Please contact ILSC I do not need ILSC Accommodation service
Check-in date (mm/dd/yy): _____ / _____ / _____ Time: _________ am pm Check-out date (mm/dd/yy): _____ / _____ / _____ Time: ________ am pm
Airport transfer: pick-up only pick-up and drop-off no Airline and Flight No.: _____________________________________________
Connecting Flight Airline & Flight No. (if applicable): ______________________ Final Destination Arrival Time: __________________________ am pm
Do you have any medical condition(s) we should be aware of? yes no What languages do you speak?:
If yes, please specify: Interests & Comments:
Do you take daily medication? yes no
If yes, please specify:
Do you have allergies? yes no
Requests are not guaranteed, but the Homestay staff at ILSC will do their best to
If yes, please specify: accommodate student requests. It is recommended that students who request airport
reception arrive and depart on the weekend. Alternative Accommodation and Residence
Do you smoke? yes no Placements are based on availability and not guaranteed. Homestay students are advised
(Most families do not allow smoking indoors.) that neither ILSC nor the Homestay family can be held responsible for the loss or theft
Do you eat: Fish Red Meat Dairy Products Eggs of personal belongings. Although the chance of a loss due to theft is extremely small, we
nonetheless advise students to ensure that they obtain adequate insurance coverage in
Are you comfortable with dogs in the home? yes no their home countries for all personal belongings that they bring to the U.S.
Are you comfortable with cats in the home? yes no
MEDICAL INSURANCE
Please specify any other pet types you are uncomfortable with:
Upon arrival, all ILSC students must show proof of valid medical insurance for
their entire term at ILSC .
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2. S T U D E N T C O N T R A C T ( S t u d e n t A g re e m e nt and Health Declara tion)
I declare that the information I have given on this enrollment form is correct and accurate. I declare that I I agree that ILSC may provide my educational records or information to my parents (if a minor) sponsoring
am in possession of sufficient funds to finance my full term of study at ILSC. I have read and understood Agency or any other Educational Institution to which I apply. I agree to save and hold harmless, ILSC its
all of ILSC’s policies including the Cancellation and Refund policies (see page 3) and agree to abide by agents, employees, homestay families and assigns for any loss, damage or injury which may occur to me
any decisions of the School’s management regarding the enforcement thereof. I acknowledge and accept or my property and hereby permanently waive all claims for loss, damage or injury resulting or arising from
that during the course of my study at ILSC or during activity programs, I may be photographed, video taped my term of attendance at ILSC. I agree as well that the violation of any of the above conditions or if any of
or audio taped and I hereby grant ILSC unrestricted and non-expiring permission and all rights to use or the information provided in this application is discovered to be false or misleading, I may be dismissed from
license such media for any advertising or promotional purposes that ILSC may deem appropriate, without ILSC without notice or recourse. I have read and understood the above and agree to be fully bound by this
any compensation whatsoever. contract and declare that I have received a signed copy of this contract.
I declare that I will disclose to ILSC any contagious medical condition that I might contract prior to or during Student signature:
my stay at ILSC and I agree to disclose any pre-existing medical or health condition that may require (or parental signature if student is underage)
ongoing or intermittent medical attention or that may affect my ability to fully participate in either classroom Date: (mm/dd/yy)
or activity programs. I hereby authorize any doctor, EHS or medical facility to provide treatment to me if I am
injured or ill whether or not I am able to provide consent. I agree and acknowledge that ILSC may collect
personal information including medical information as a result of this application and/or my time at ILSC and ILSC Authorized signature:
acknowledge that this information will only be used in the course of the provision of educational, ancillary
Date: (mm/dd/yy)
and medical services either directly or indirectly and for no other purposes.
C R E D I T C A R D PAY M E N T
MasterCard Visa Name of cardholder: Cardholder signature:
Credit card number: Expiry date: Total payment: $
2010 ILSC Fee Schedule
R E G I S T R AT I O N F E E S AC C O M M O D AT I O N F E E S
All prices are in US dollars. Fees due effective october 1, 2009 Homestay (18 and older)*
• Single room with 2 meals per day:
(Based on the registration date, not study start date) Availability of the program $ 252 / week
is subject to student enrolment. • Single room with breakfast only: $ 217 / week
• Shared room with 2 meals per day: $ 210 / week
Registration Fee: $ 100 (non-refundable) • Shared room with breakfast only: $ 175 / week
Accommodation Registration Fee: $ 150 * Students under 18, please add $14 / week on above fee.
(if applicable, non-refundable) Student Residence/Alternative Accommodation: Please contact ILSC.
Materials Fee: $ 60 (for students studying 3 to 12 weeks) Airport Transfer: $ 95 (One-Way)
$ 120 (for students studying 13 weeks and more) $ 180 (Two-Way Package)
CORE FEE SCHEDULE / PER WEEK
1 lesson = 50 minutes
Length of Study Full-Time Intensive (28 lessons) Full-Time (20 lessons) Semi Full-Time (16 lessons)
Mon – Thu: 9 A.M. – 3 P.M. Mon – Fri: 9 A.M. – 12:30 P.M. Mon – Thu: 1:20 P.M. – 4:50 P.M.
Fri: 9 A.M. – 12:30 P.M.
1 – 3 weeks $360 $315 $235
4 – 11 weeks $350 $300 $225
12 – 15 weeks $330 $210
16 – 23 weeks $320 $280 $200
24 – 31 weeks $300 $185
32+ weeks $280 $235 $175
S P E C I A LT Y P R O G R A M F E E S
Program Length of Program Description Start Dates Cost
english In Action 1 to 4 weeks 20 lessons in the morning, followed by Every Monday $ 405/ week
organized afternoon activities
english on the Road: 3 to 4 weeks 2 to 3 weeks of 20 lessons followed by 1st or 2nd Monday 2 weeks study + Tour Package: $1780
California 8 days of California Tour of each Session 3 weeks study + Tour Package: $2095
California tour: $1150
youth Summer 1 to 7 weeks Program for students at 13 – 17 years of age June 27, July 4, 11, 1 wk $1390, 2 wks $2140, 3 wks
Program English study plus activities 18, 25, Aug 1, Aug 8 $2890, 4 wks $3640, 5 wks $4390,
End date: Aug 14 6 wks $5140, 7 wks $5890
T U I T I O N C A LC U L AT I O N W O R K S H E E T
Registration Fee: $ Total Accommodation fee*: $
Materials Fee: $ Airport Transfer
Total Tuition Fee: $ (one way/package)*: $
Accommodation Registration Fee*: $ Courier Fee*: $
Total Fees: $
02 | *if requested
3. M E T H O D O F PAY M E N T B A N K I N G I N F O R M AT I O N
Payment can be made by credit card, cheque, money order, or bank transfer.
Transfer U.S. funds to:
1. Credit Card
We accept Visa or Mastercard. Please fill out the credit card payment section BAnk oF AMeRICA
(on the second page). 500 Battery St.
2. Money order or cheque (drawn on a U.S. bank) San Francisco CA 94111
Make it payable to: ILSC (San Francisco) LLC
Account number: 07698 66706
Mail it to: ILSC San Francisco
one embarcadero Center, Lobby Level Swift Code: BoFAUS3n
San Francisco, CA 94111-3607, USA
G E N E R A L I N F O R M AT I O N
A DM I S S Io n R e q U I Re M enTS
ILSC accepts students 16 years of age and older. Some programs and courses have specific English level requirements.
I L S C AP P L I C AT Io n C H e C k L I S T
Complete and sign the application
Fax or mail your application form and financial certification in English (if requesting a Form I-20) to ILSC San Francisco
Pay Registration Fee, Accommodation Registration Fee*, and Courier Fee* by one of the payment methods (*if requested)
After the application is accepted, we will send you I-20** Form (if requested) and Letter of Acceptance, which will give you more information about your next steps.
F I n An C I A L C eR T I F I C ATIon START DAT eS
If you require an I-20 Form, you must submit financial certification showing that you will have ILSC accepts new students every Monday, year round, except the last Monday of a session.
sufficient funds available for your tuition and living expenses while studying at ILSC. Please If you start classes on the 2nd or 3rd Monday of a session, you may be placed in an ongoing
provide one of the following forms of certification. class. Students registering for English on the Road–California must start on session start dates
for the 4 week program and on the second Monday of the session for the 3-week program.
• A current personal bank statement or letter from your bank
• A letter of support from your parents/sponsor stating that they will be responsible for your yoUR F IRST DAy
expenses during your stay, and a bank statement or letter verifying their financial ability On your first day at ILSC, you will take the ILSC Placement Test (written and oral test) and
to meet your expenses choose your classes of interest. While an Academic Coordinator places you in classes that
• A letter guaranteeing financial support from a sponsoring organization meet your interest and English level, an ILSC Counselor will welcome you and provide
• A scholarship letter from your government important information that will help your studies at ILSC and life in San Francisco. Classes
begin on Tuesday.
v I SA
Students without an F-1 Student Visa cannot choose the Full-Time Intensive schedule as CoURSe Se LeCTIonS
they are not permitted to study more than 18 hours a week. Each session, ILSC offers a variety of courses to choose from. In the fourth week of each
session, students will discuss the courses they want to take in the coming session with
Students who apply for an F-1 Student Visa must register for a minimum of 4 weeks and in a their teachers. Students will be placed in the courses of their interest if their English level is
Full-Time Intensive or Full-Time schedule. appropriate for the courses. In case courses are not available, the Head Teacher will place
students in the students’ next choices.
** ILSC CAnnoT ISSUe I-20’s UnTIL We HAve Been APPRoveD ATT enDAnCe
By SevIS. We exPeCT THIS To oCCUR By JUne 2010. In order to get the maximum benefit from your study at ILSC, you are expected to attend
class regularly and on time. You need to attend at least 80% of your classes each session,
as part of the requirement to receive a credit for each course taken. You are required to
PAy Me n T oF F e e S speak with your counselor if you need permission for unavoidable or excessive absences.
Registration Fee, Accommodation Registration Fee, and Courier Fee must be paid at the
time of registration. The balance of fees, including full tuition and accommodation fees must engLISH onLy PoLIC y
be paid prior to your first day at ILSC. In order to encourage the use of English, we have an English Only Policy in the school. This
means that whenever you are in the school or participate in the class/school activities, you
must speak English.
C A N C E L L AT I O N A N D R E F U N D P O L I C Y D I S P U T E R E S O LU T I O N P O L I C Y
To receive a refund of any portion of tuition fees, you must give ILSC written notice that you intend to ILSC encourages its students to talk freely about their lives and experiences in the school and
withdraw from the program in which you have enrolled. If your Study Permit or visa is denied, ILSC will in San Francisco. Comments about the school’s program help everyone to learn and become
retain the $100 non-refundable Registration Fee and if applicable, the $150 Accommodation Registration
better. Students should share any difficulties or challenges they are facing. The teachers,
Fee. If you cancel in writing before your program starts, you will receive a refund of all fees paid less
non-refundable charges. student counselors and school administrators are available to listen to and guide students. If a
student has a difficulty with the school itself, which cannot be corrected through discussion, then
An F-1 student visa with I-20 issued by ILSC and you cancel before your program starts or do not show up the student can present his/her concern in writing to the School Director, who will, in discussion
for class, we will retain the first 4 weeks of tuition fees as well as all non-refundable charges up to $350. and in writing, address and resolve the dispute.
• Less than 4 weeks completed (- of a 4 week or less program*): no refund
• Less than 4 weeks completed (- of a program more than 4 weeks long): no refund for the first 4 weeks, and
then prorated refund for amounts greater than those 4 weeks tuition, less non-refundable fees up to $350. DISMISSAL POLICY
However, students who have completed 50% or more of their registered program will not be entitled to
any refund. Students must keep good attendance and attend at least 80% of their classes. Students must
• More than 4 weeks completed: no refund for the first 4 weeks, and then prorated refund for amounts greater speak only English when on school premises. If these expectations are not met, students will
than those 4 weeks tuition, less non-refundable fees up to $350. However, students who have completed 50% receive counseling. Then, after appropriate warnings, students will be expelled. Likewise, if
or more of their registered program will not be entitled to any refund.
• Prorated refunds will be calculated on a weekly basis with a partial week being considered a whole week.
a student’s behavior is inappropriate by the school’s standards, the above procedures will
be followed.
Change of schedules is considered the same as cancellation. For example, for a schedule change of
full-time intensive (28 lessons/week) to full-time (20 lessons/week), you will have to cancel the whole
program and re-apply for the full-time program. Monetary charges as indicated above will apply. C O N TAC T I N F O R M AT I O N
Specialty programs are not transferrable to core programs. If you change your program from a specialty
program to a core program, you have to cancel the specialty program and re-apply for the core program.
ILSC SAn FRAnCISCo
one embarcadero Center, Lobby Level
If you are eligible for a refund under the conditions above, you will receive the refund within 45 days of San Francisco, CA 94111-3607, USA
ILSC receiving written notice of cancellation or ILSC’s notice to you of dismissal.
Phone: 415.677.9961 Fax: 415.677.9591
*Program is defined as whatever length of time a student registers for. email: study@ilsc.com
www.ilsc.com/san-francisco
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4. 2 0 1 0 / 2 0 1 1 S C H O O L C A L E N D A R
JANUARY FEBRUARY MARCH JANUARY FEBRUARY MARCH
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APRIL M AY JUNE APRIL M AY JUNE
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J U LY AUGUST SEPTEMBER J U LY AUGUST SEPTEMBER
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OCTOBER NOVEMBER DECEMBER OCTOBER NOVEMBER DECEMBER
S M T W T F S S M T W T F S S M T W T F S S M T W T F S S M T W T F S S M T W T F S
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Indicates the start of a new session Indicates holiday or official school closure
Please note - 1. One school session is 4 weeks. 2. Student intake is every Monday, except last Monday of a session. 3. If you start on the 2nd or 3rd Monday of a session, you may be placed in an ongoing class.
W W W . I L S C . C O M / S A N − F R A N C I S C O