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2008 APPLICATION AND I-20 REQUEST FORM

FOR THE SIX-WEEK INTENSIVE PROGRAM

Term name:_____________________________

Month term begins:_______________________ Year of term:_____________

 

Student Name (as it appears on the student's passport):

Last Name: ______________________________

First Name: __________________________ Middle Name: _____________________

Birthday: Month: ______________ Day: ____________ Year: _____________

Male or Female

Country of Birth: _________________ Country of Citizenship: _______________

 

Mailing Address for I-20:________________________________________________

______________________________________________________________________

Postal Code:_____________________ Country: ______________________________

Student's Home Address (if different): ____________________________________

______________________________________________________________________

Postal Code:_____________________ Country: ______________________________

 

Telephone Number: ______________________ Fax Number: ____________________

E-Mail Address: ________________________________

I would like to attend the MLC intensive English program beginning month__________, year______. I am enclosing the $100.00 non-refundable advanced tuition deposit or the MasterCard/Visa Authorization Form. The $100.00 non-refundable deposit will be applied to my first term's tuiton. Please send me the Form I-20.

STUDENT SIGNATURE__________________________ Date:_________________

(If you plan to come to the United States with dependents, please notify the MLC.)

 

 

UNIVERSITY TOWERS HOUSING REQUEST FORM AND CONTRACT

__ Do not reserve housing for me.

__ I would like to reserve a shared bedroom at University Towers. I understand that I will share one bedroom in a two-bedroom apartment, and that the second bedroom will have one or two other students. I understand that the cost of a shared bedroom is $790 per term*. I am enclosing the $200 non-refundable housing deposit or MasterCard/Visa Authorization Form for $200. The $200 non-refundable deposit will be applied to the rent.

__ I would like to reserve a single bedroom at University Towers. I understand that I will have my own bedroom in a two-bedroom apartment, and that the second bedroom will have one or two other students. I understand that the cost of a single bedroom is $1275 per term*. I am enclosing the $300 non-refundable housing deposit or MasterCard/Visa Authorization Form for $300. The $300 non-refundable deposit will be applied to the rent. (There are a limited number of single rooms available)

*Housing costs are subject to change

__ OPTIONAL BED & BATH PACKAGE: Please reserve an optional Bed and Bath Package for me. The cost of a Bed & Bath Package is $65. I understand that I must reserve a Bed & Bath Package in advance and that the Bed & Bath Package contains the following: Blanket; Pillow; Pillowcase; Bath towel; and Hand towel. These items are sold as a package, If a student does not reserve a Bed & Bath Package in advance, the student should bring these items from his/her own country.

 

ADDITIONAL HOUSING RELATED CHARGES PER PERSON

Utility Charge: 6-week term=$40/person (Term 5 and Term 6 = $55/person)

3-week term=$30/person 9-week term=$70/person

Cleaning Fee: $30/person for each 3-week or 6-week term

Refundable Key and Damage Deposit: When a student first moves into University Towers, a $150 refundable damage deposit is collected from each student to cover the cost of the keys and damage to the apartment. The deposit is returned to the students within 30 days after the student leaves the apartment if the keys are returned and there is no damage to the apartment.

 

I have agreed to rent either a shared or a single bedroom for the term stated on the application on the other side of this page. I understand that if I have reserved a shared or a single bedroom at University Towers and I have entered the United States, I am responsible for paying the total housing fee for the term unless I cancel my reservation in writing one week prior to the published University Towers move-in date. If I continue to study at the MLC for additional terms, I will have the option to continue to rent at University Towers or to arrange my own housing.

STUDENT SIGNATURE__________________________ DATE_________________

 

 

 

 

 

STATEMENT OF FINANCIAL RESPONSIBILITY

Applicant's Name (Typed or Printed)_____________________________________________________

I understand that the tuition at the Michigan Language Center is $1250.00* for each six-week term, and books cost approximately $100.00 per six-week term. Living expenses are estimated to be between $1465.00 and $2000.00 for each six-week term. Therefore, an intensive student at the MLC should have at least $2950.00 available to him or her for each six-week term of study to pay for tuition, books and living expenses. I agree to be responsible for these expenses.

Signed___________________________________________________Date_______________________

* Tuition is subject to change.

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Michigan Language Center
309 S. State St.
P.O. Box 8231
Ann Arbor, MI 48107, U.S.A.
Tel: (734) 663-9415
Fax: (734) 663-9623
E-Mail: MLC-USA@worldnet.att.net

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