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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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