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AEI Virtual
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Application
(Students who do NOT require F1 Visa)
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Download Application
Personal Information
*
Last name
*
First (given) name
Middle name
Name you wish to be called at school
*
Date of birth
Month
Jan
Feb
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Dec
Date
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Year
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1994
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Sex
Male
Female
Contact Information
Street 1
Street 2
City
State
Postal/Zip Code
Phone
Other phone
Fax
*
E-mail
Other e-mail
Emergency Contact
*
Emergency contact name
*
Emergency contact phone
*
May we use this contact for non-emergencies?
Yes
No
Attendance Plan
*
Intended start date
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Date
1
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Year
2008
2009
2010
*
Planned end date
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Date
1
2
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Year
2008
2009
2010
*
Initial course
-- Please Select --
Intensive Course/Program
Collegiate and Professional English (CAPE) Program
Business English
Youth Program
Tutoring
Test Preparation
*
Course times
Mornings
PM/Evenings
Goals and Academic Requirements
Please answer the following questions:
What are your short and long term goals?
Are you willing to do your part in order to succeed at the Atlanta English Institute? (Your part includes arriving on time, attending all classes, completing assigned homework, and participating fully in class.)
Yes
Other
*
How did you find out about the Atlanta English Institute?
Referral. Please specify
Newspaper. Which newspaper?
Internet. Please specify
Other. Please specify
Native Language
Certification
*
I certify that the information on this application is true. In addition, I have read, understood and agree to
AEI's policies
.
Yes
Comments/Other
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