golden gate english language school

STUDENT APPLICATION FORM
Application Instructions | Registration Checklist | Student Application Form

Please print out and complete this form
1. Applicant's Name:
Family Name 

First Name                          Middle Name
2. Gender: Male  Female 
Date of Birth
month/day/year		 /  / 
3.  Birthplace: 
City / (Province) / Country
  Country of Citizenship:
4. Applicant's US Address:
Street Address                                   Apt. # 


City                      State                  Zip 

  US Telephone: Day:

Evening:


Area Code         Number
Area Code         Number
  Fax:
Area Code         Number
  E-mail:
5. Applicant's Home Country
Address:
Street Address 


City                  Country            Postal Code
  Telephone:
Area Code         Number
  Fax:
Area Code         Number
  E-mail:
6. Contact Person in US:
Family Name                       First Name

Relationship
  Day Telephone:
Area Code         Number
  Evening Telephone:
Area Code         Number
7. When do you want to study at GGLS? From:  To: 
Month/Day/Year Month/Day/Year
8. Do you want to apply as an international student?   Yes  No 
(If yes, please complete questions #10-19.)
9. I certify that the information submitted is complete and correct and that I understand the Terms and Conditions.

 Signature _____________________________________________________________________
Applicant                                Name Printed                        Date

Application for International Students
Complete items #10-19 if you wish to apply as an international student. This school is authorized under Federal law to enroll nonimmigrant alien students.
10.

How many sessions do you plan to study at GGLS? _______ # of sessions

The US Immigration Service requires that you have enough money to cover school and living expenses for the total time you plan to stay at the school. See the section, International Student, Estimated Expenses, for the dollar amount needed.

11. The funds needed for school and living expenses will come from the following sources (check all that apply): 
    Personal Savings (Applicant can sponsor himself/herself)
    Family Funds from abroad or in the US
    Sponsor abroad or in the US
12. To verify each item checked above, please attach a certified bank letter in English, showing account balance in US Dollars. This letter must be on original bank letterhead and signed by a bank official.
13. Name of Sponsor:
Family Name                       First Name

Relationship
  Address:

City              State/Country         Postal/Zip Code
  Day Telephone:
Area Code     Number
  Evening Telephone:
Area Code     Number
  Fax:
Area Code     Number
  E-mail:
  Signature: _____________________________________________________________________
      Sponsor                                        Name Printed                                      Date
14. You can receive a substantial savings by paying for 2 sessions when you first enroll. This offer is available to new International Students. After this period, the discounted tuition is charged one session at a time for continuing students.

Do you want to apply for (check one):
    1 session
    2 sessions
15. Are you a transfer student? Yes  No If yes, please complete Transfer Verification Form
16. Do you have dependents? Yes  No If yes, please complete Dependent Information Form
17.
Do you have a current SEVIS I-797 payment receipt? (Check one)
 
Yes. Enclose a copy of the I-797. (The date on the receipt must be within 12 months from the date of your visa interview for this application.)
No. GGLS will obtain the form I-797 for you.
18.
Medical Insurance is required for international students. (Check one)
 
    I will need to purchase medical insurance. 
    I will provide proof of medical insurance coverage upon my arrival. 
19. Delivery instructions for enrollment documents: (Check one)
 
    Mail - US Address 
    Airmail - Foreign Address 
    International Express Mail (additional fee) 
    Pick-up at Golden Gate Language Schools 
Homestay Application
  Applicant's Name:
20. Submit this completed application at least one month before you plan to move in with a Host Family. Be sure to attach a personal photo or family photo. See Accommodations for more details.
  Date you plan to move in with host family: 

 Month/Day/Year 
  Date you plan to move out.

 Month/Day/Year 
  How long have you studied English?
Years 
  What type of accommodations do you prefer? 
Executive Standard room with meals Standard room without meals
Do you smoke? No, I do not smoke and I will not live with a family that smokes.
No, I only smoke sometimes.
Yes, I smoke.
 
SMOKERS, PLEASE NOTE: Many families in California do not host students who smoke. Of the families that permit smoking, all require smoking outdoors. Please be aware that you will not be permitted to smoke inside the house.

 
Would you stay at a home that has a small dog?
Would you stay at a home that has a large dog?
Would you stay at a home that has a cat?		 Yes
Yes
Yes 		No
No
No
Do you have any allergies or other health problems? Yes No

If yes, please explain________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Are there any foods you cannot eat? Yes No
If yes, please list________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
 
 
   Please tell us something about yourself such as your hobbies, interests, etc.
Airport Pickup Application
21.
Golden Gate Language Schools can provide pickup and return service for either San Francisco Airport or San Jose Airport. (See Price List for charges.) If you need to be picked up at the airport, please give the school at least two weeks advance notice and fill out the form below. Airport return can be arranged with the Host Family Coordinator two weeks before leaving the school.
 

Applicant's Name:

Do you need to be picked up at the airport? 

No, I do not need to be picked up.

Yes, I will send the flight information at a later date (at least 2 weeks before I arrive).

Yes, here is the flight information:


Flight Information

Airline and flight number

Arrival date and time:


Airport Information 

-San Francisco 

-San Jose 

Application Instructions | Registration Checklist | Student Application Form

To submit this application, please follow Application Instructions.

Golden Gate Language Schools
591 W. Hamilton Avenue, Suite 101
Campbell, California, 95008-0521, USA
Phone: 1 (408) 374-9954
Fax: 1 (408) 374-9429
info@goldengatelanguage.com

Copyright © 1998 - 2008 Golden Gate Language Schools, Inc.