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 MICHIGAN LANGUAGE CENTER APPLICATION AND I-20 REQUEST FORM FOR THE 6-WEEK INTENSIVE PROGRAM

 

I would like to study intensive English at the Michigan Language Center during the following term: ________________(month) _____________(year).

I am enclosing the $100.00 non-refundable advanced tuition deposit or the MasterCard/Visa authorization form. This $100.00 advanced tuition deposit will be applied to my first term's tuition. Please send me the Form I-20.

Name__________________________________________________________________________________
Family First
Country of Birth_______________________________Country of Citizenship___________________ Birthday (Month, Day, Year)_____________________________ Male__________Female _________
Complete Address_________________________________________________________________________
Complete Address_________________________________________________________________________
E-Mail Address ___________________________________________________________________________
Fax #____________________________________Telephone #_____________________________________
If you are coming to the United States with a dependent(s), please list their names (family, first), relationship to student (wife, husband, son, daughter), date of birth (month, day, year) and country of citizenship.

Signed_____________________________________Date_________________________________________

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 the cost of a shared bedroom is $790.00 per term. I am enclosing the $200.00 non-refundable housing deposit or MasterCard/Visa authorization form. The $200 will be applied to the rent.


I would like to reserve a single bedroom at University Towers. I understand that the cost of a single bedroom is $1275.00 per term.* I am enclosing the $300.00 non-refundable housing deposit or MasterCard/Visa authorization form. The $300 will be applied to the rent. (There are a limited number of single rooms available.)

 


Please reserve a Bed and Bathroom Package for me. I have enclosed $65.00.
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. If a student does not purchase a Bed and Bathroom Package, the student should bring these items from his/her own country. A Bed and Bathroom Package must be reserved in advance.

 

ADDITIONAL HOUSING RELATED CHARGES PER PERSON:
Refundable Key and Damage Deposit:
$150.00 to cover the cost of the keys and damage to the apartment. If the keys are returned and if there is no damage, the deposit is returned 30 days after move-out.

Utility fee: $40.00; $55.00 for Terms 5 and 6 only.

Cleaning fee: $30.00 per term

 

I understand that I have agreed to rent either a single bedroom or a shared bedroom for the term stated in the application form above. 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 my studies at the MLC after the six-week term, I will have the option to continue to rent a bedroom or I will be able to arrange my own housing.

Signed___________________________________________ 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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