| 1. |
申込者のお名前: |
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| 2. |
性別: |
| 男性
女性 |
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| 3. |
住所: |
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Street
City
State
Postal Code
Country |
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| 4. |
E-メール: |
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| 5. |
電話番号: |
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| 6. |
ファックス番号: |
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| 7. |
生年月日: |
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| 8. |
出生国: |
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County
City |
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| 9. |
国籍: |
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| 10. |
最終学歴: |
| 高校
短大・大学
その他
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| 11. |
I-20申請書を希望しますか?(I-20申請書を受け取るには、$50の申込金をお支払い頂きます。) |
| はい
いいえ |
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| 12. |
ご希望のセンターをチェックしてください: |
| Washington,
DC
Gaithersbirg, MD |
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| 13. |
2008年の入学希望日をチェックしてください: |
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| 14. |
上記の入学日に入学できない場合は、ご希望の入学日をご記入ください: |
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| 15. |
Washington, DC センター入学を希望の方に伺います。ホームステイを希望しますか?(オンライン・ホームステイお申し込みフォームへの記入も忘れずにお願い致します。) |
| はい
いいえ |
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| 16. |
Payment Policy
Acknowledgement:*
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I understand that all tuition is due the first day of class.
I understand that I will be charged a late fee of $15 for
any tuition more than 3 days late. I understand that I can
not re-enroll for classes until I have paid all open
balances.
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| 17. |
Refund Policy Acknowledgement:* |
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I agree to Transemantics/ILI's refund policy: All fees are
non-refundable. Once received by the student, books and
other materials sales are final. If a course is cancelled by
Transemantics/ILI, a full refund will be given. Cancellation
by the student prior to commencement of class, will result
in the forfeiture of the application fee or any other fees;
but not the tuition. In the event of early withdrawal after
the commencement of classes, but prior to completion, the
prorated portion of the unexpended tuition will be refunded.
Any portion of a week in attendance will be considered a
full week of attendance. Refunds will be issued within 30
days of receipt of written notification from the student.
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| 18. |
VisaまはたはMasterCardでのお支払いを希望しますか? |
| はい
いいえ |
| カード番号 |
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| 有効期限
CVV Code:
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| Street Address of
Billing Statement: |
Postal Code of
Billing Statement:
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