APPLICATION PROCESS FOR APPLYING TO ATTEND THE SPECIAL 3-WEEK INTENSIVE PROGRAMS

To register for the Term 5A, 5B, 6A, 6B, or Holiday 3-Week programs, please print the following application form, complete it and sign it in the appropriate places. Mail your application form with a $100.00 non-refundable tuition deposit. The remainder of the tuition, $660.00 will be due on registration day. Students will also be expected to purchase textbooks at a local bookstore. Space is limited and each applicant will be considered on the basis of the arrival date of his/her application and deposit.

PLEASE NOTE: A student who is interested in attending Terms 5A and 5B, or 6A and 6B should consider attending the Term 5 or Term 6 6-week intensive program. The cost of attending the Term 5 or Term 6 6-Week Intensive Program is much less than the combined costs of the 3-Week Intensive Programs.

APPLICATION FORM FOR A 3-WEEK INTENSIVE ENGLISH PROGRAM
I wish to apply for the following program:     Term 5A 3-Week Intensive Program
or Term 5B 3-Week Intensive Program  Term 6A 3-Week Intensive Program
or Term 6B 3-Week Intensive Program   Holiday Term 3-Week Intensive Program

Family name:_______________________________________________________________________

First name:_________________________________________Middle name:_____________________

Birthday (Month, Day, Year):_________________________ Male / Female (circle one)

Country of Birth: ___________________________Country of Citizenship:_____________________

Complete Address:___________________________________________________________________

__________________________________________________________________________________

Fax#:_________________________________ Telephone#:__________________________________

E-Mail Address:_____________________________________________________________________

Signed ______________________________________________Date __________________________

University Towers Housing Request Form and Contract

Do not reserve housing for me. I will make my own housing arrangements.

I would like you to reserve a shared bedroom for me at University Towers. I understand that the cost of a shared bedroom during the Special Summer Session is $530.00 in addition to a $30.00 per term cleaning fee and a $30.00 per term utility charge. I am mailing you a non-refundable housing deposit of $200.00 which will be applied to my rent.

I would like you to reserve a single bedroom for me at University Towers. I understand that the cost of a single bedroom is $780.00 during the Special Summer Session in addition to a $30.00 per term cleaning fee and a $30.00 per term utility charge. I am mailing you a non-refundable housing deposit of $300.00 which will be applied to my rent.

Refundable Key and Damage Deposit: When a student first moves into University Towers, a $150.00 refundable deposit is collected from each student to cover the cost of the keys and damage to the apartment. This deposit is returned to the student within 30 days after the student leaves the apartment if the keys are returned and if there is no damage to the apartment.

Optional Bed and Bathroom Package: A student may purchase a Bed and Bathroom Package from the MLC for $65.00. The Bed and Bathroom Package includes the following: 1)Fitted bottom sheet; 2)Top sheet; 3)Blanket; 4)Pillow; 5)Pillow case; 6)Bath towel; 7)Hand towel. These items are sold as a package only. It is not possible for the MLC to lend or sell part of a Bed and Bathroom Package. A Bed and Bathroom Package must be reserved in advance. If a student does not purchase a Bed and Bathroom Package, the student should bring these items from his/her country.

I would like to reserve a Bed and Bathroom Package for my apartment at University Towers. I have enclosed $65.00. I understand that the MLC will provide me with the following: 1)Fitted bottom sheet; 2)Top sheet; 3)Blanket; 4)Pillow; 5)Pillow case; 6)Bath towel; and 7)Hand towel.

OR

I do not want to reserve a Bed and Bathroom Package. I understand that I must bring my own sheets, pillow, pillow case and towels and that the MLC will not provide me with these items.

Signed _____________________________________________Date ___________________________

STATEMENT OF FINANCIAL RESPOSIBILITY FOR THREE WEEK INTENSIVE PROGRAM

I understand that the tuition at the Michigan Language Center is $760.00 for the three week term, and the cost of materials will be beween $70.00-$90.00. Living expenses are estimated to be $785.00 for the three week term. Therefore, an intensive student at the MLC should have $1600.00 available to him or her for the three week term of study to pay for tuition, books and living expenses. I agree to be responsible for these expenses.

I also understand that the Michigan Language Center will notify the Immigration and Naturalization Service if a student arrives in the United States without adequate funds or if a student does not maintain his or her student status by studying full time.

Signature of applicant_____________________________Date________________________________

Signature of person who is financially responsible for applicant _______________________________

Date________________________________

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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