Student Application



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Student Application
Students are expected to have a basic vocabulary, understand very simple oral language, and be able to write simple sentences in English. Students who have successfully completed at last one year of English as part of their school studies or one course at a language institute or have other English experience typically satisfy the basic knowledge requirement. Students who are not sure if they meet this minimum requirement should submit a short sample of their writing with their application.
Application Instructions
Your application file will be reviewed only after all the required documents have been received. Please be sure to include the following when submitting your application:
 A completed application form, signed and dated

 An official copy of your high school or university grades


 An official financial support statement from your bank, sponsor or guardian certifying that you have at least US $6,000 available for your first term at INTERLINK
 A photocopy of your passport (identity page) and of your dependents (if applicable)

 $100.00 non-refundable application fee

 Optional express mail fee of $65.00
Payment Options:


  • Bank Wire – contact the center you are applying to for wiring instructions

  • Check – make check payable to INTERLINK Language Centers

  • Credit Card – download the credit card authorization form from the Application

Process page on www.interlink.edu
Fax, mail or e-mail application materials directly to the appropriate center:

INTERLINK Language Center



Indiana State University

Root Hall, Room A141S

Terre Haute, Indiana

USA 47809

Fax: (812) 237-8031

isu@interlink.edu

INTERLINK Language Center



The University of North Carolina at Greensboro

Foust Building, Room 205 Greensboro, North Carolina

USA 27402-6170

Fax: (336) 334-4701



uncg@interlink.edu

INTERLINK Language Center



Valparaiso University

60 University Dr. Suite 100

Valparaiso, Indiana,

USA 46383-6493

Fax: (219) 464-6846

vu@interlink.edu

For INTERLINK at St. Ambrose University, send your application materials to Home Office:


INTERLINK Language Centers

890 W. Cherry St., Suite 200

Louisville, CO

USA 80027





I. Required Information

You must fill out all the information in this section. If you omit any required information, Your application will not be submitted. Where applicable, enter the information as it appears on your passport.


Please select the center you wish to attend:

 Indiana State University

 The University of North Carolina at Greensboro

 St. Ambrose University

 Valparaiso University

Expected start of INTERLINK studies: Month_____ Year_____

Family Name: ___________________________________
First Name: ____________________________________
Email Address: __________________________________
Telephone Number: ______________________________
Address (residence)

Do not leave any section blank. If there is no State or Province or no Postal Code, write “none.”


P.O. Box or Street Number: ___________________________________

City: _________________________________________

State or Province: _______________________________
Postal Code: ___________________________________
Country: ______________________________________
Mailing Address

If your mailing address is the same as your residence, write “same” below. If you mailing address is different, write your complete mailing address below.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Fax Number: ___________________________________________
Country of Birth: ________________________________________
Country of Citizenship: ___________________________________
Date of Birth: Day______ Month______ Year______

Your Date of Birth must be the same as on your passport.
Gender:  Male  Female
Emergency Contact

Name: __________________________________________________________________


Address: ________________________________________________________________
Telephone Number: ___________________________________
Email: ______________________________________________
Fax Number: _________________________________________
Marital Status:  Married  Unmarried
If married, will your family accompany you?  Yes  No
If yes, complete Part III below.
II. Academic Information

Please answer all questions below as accurately as possible to facilitate the application process.


How many weeks do you expect to study at INTERLINK? _________
Where did you first hear about INTERLINK?

 Friend  INTERLINK Center  INTERLINK Website

 Relative  INTERLINK Representative  Facebook

 INTERLINK Student  Study Abroad Agency  Twitter

 Fulbright Office  INTERLINK Advertisement  LinkedIn

 USIS Advertising  Internet Search  Other

What do you plan to do after you study at INTERLINK?

 Study for BA/BS  Study for MA/MS  Study for PhD

 Return home  Travel in the US  Other
Highest education level completed:  Secondary  University
Your field of study (major): ________________________________________________
Standardized English test

Name of test:  TOEFL  TOEIC  Michigan  Other  None


Score: ____________________________­­­­_
Date: Day_____ Month _____ Year _____
Rank your English ability

Speaking:  Very Good  Good  Fair  Poor  No Ability

Listening:  Very Good  Good  Fair  Poor  No Ability

Reading:  Very Good  Good  Fair  Poor  No Ability

Writing:  Very Good  Good  Fair  Poor  No Ability
Have you studied in the US before?  Yes  No

If yes, name of program: __________________________________________________

Address of program: _____________________________________________________

Rank housing options in order of your preference

1st Choice:  No Housing Assistance Needed  University Residence Hall

Host Family  Apartment


2nd Choice:  No Housing Assistance Needed  University Residence Hall

 Host Family Apartment


3rd Choice:  No Housing Assistance Needed  University Residence Hall

Host Family  Apartment


Do you have any physical disability or health problems that will require special assistance?

 Yes  No

If yes, explain: ___________________________________­­­­­­­­­­_______________________
Who will finance your education in the US?  Self  Family  Government  Other
If other, please specify: _________________________________­­­­­­­­­­__________________
Do you wish to receive your admission materials via express mail?  Yes  No

The charge for this service is $65


III. Family Members

You only need to complete this section if family members will be accompanying you to the United States.
Please answer all questions below as accurately as possible to facilitate the application process. Information must be exactly as it appears on passports. 
Spouse

Information must be exactly as it appears on passport.
Full Name: _________________________________________

Date of Birth: Day_____ Month_____ Year________________

Country of Birth: _____________________________________

Country of Citizenship: ________________________________




Child 1

Information must be exactly as it appears on passport.

Full Name: ____________________________________________________________

Date of Birth: Day_____ Month_____ Year__________

Gender:  Male  Female

Country of Birth: _______________________________

Country of Citizenship: __________________________


Child 2

Information must be exactly as it appears on passport.

Full Name: ____________________________________________________________

Date of Birth: Day_____ Month_____ Year__________

Gender:  Male  Female

Country of Birth: _______________________________

Country of Citizenship: __________________________



Child 3

Information must be exactly as it appears on passport.

Full Name: ____________________________________________________________

Date of Birth: Day_____ Month_____ Year__________

Gender:  Male  Female

Country of Birth: _______________________________

Country of Citizenship: __________________________


Child 4

Information must be exactly as it appears on passport.

Full Name: ____________________________________________________________

Date of Birth: Day_____ Month_____ Year__________

Gender:  Male  Female

Country of Birth: _______________________________

Country of Citizenship: __________________________



Agreement Terms
I understand the terms of my admission and agree to abide by the rules of the INTERLINK Language Center and of the University. I, and/or my sponsor, will be fully responsible for the cost of my studies while at INTERLINK. Further, I authorize release of my credentials and of my medical records for medical and insurance purposes; I also authorize treatment of any illness or injury by qualified health personnel during my attendance at INTERLINK.
I AGREE

_________________________________________ _____________________



Applicants or Sponsors Signature Date


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