The INTENSIVE ENGLISH LANGUAGE CENTER (IELC) 

at the UNIVERSITY OF NEVADA, RENO 

Information :  Type or Print Clearly
Name (as listed on passport)   
Last Name (Family Name) First Name Middle Name  U.S Social Security Number (if known)
Complete Current Mailing Address (Include City and Country):  
Email Address:  Telephone:      Fax:
 (Include Country Code and City Code)                  (Include Country Code and City Code)
Complete Permanent Address (if different than mailing address):  
(Include City and Country)
Gender:  Male    or    Female  

Birthdate :
Applicant's Place of Birth:   Citizenship:
                                                          (City)                         (Country)  

 (Country)
Emergency Contact:  Name:  Relationship:
Complete Mailing Address  (Include City and Country):      Telephone: 

                 

Semester and Year you wish to enter: 
  Fall    Year
  Fall Mid-Semester    Year
  Spring    Year
  Spring Mid-Semester    Year

  Summer both Modules

 10 Weeks

   Year

  Summer Module I

 5 Weeks

   Year

  Summer Module II

 5 Weeks

   Year

Do you wish to apply for an F-1 visa ? 

Yes No

  • If No, what type of visa/permanent residency will you have ?

Please be aware that you must apply for an F-1 visa if your primary purpose for being in the U.S. is study.

 
 

Are you currently attending another school in US ? 

Yes No

  • If Yes, please include a photocopy of your current school's I-20 or IAP-66, the Visa page from your passport, and the front and back of your I-94 (small white card stapled in your passport).

 

Do you have family members who will accompany you ?

Yes No

  • If Yes, please provide additional financial documentation in the amount of $7,000 for a spouse and $3,000 for each child. Please list family information on a separate page.
    (Family Name, First Name, Relationship, Date of birth, City and Country of Birth)

 

Send me information about housing  for : 

Apartment  Dormitory

 
 
Please tell us how you learned about our program.
Financial Statement: This certifies that I will be financially responsible for   (Applicant's Name)    
during the time he/she is enrolled at the Intensive English Language Center at the University of Nevada, Reno.( Attach documentary evidence to indicate availability
of funds -a letter from the bank or financial institution stating that funds are available.) No I-20 will be issued unless this form is completed.

________________________________________________

SIGNATURE (The person whose name is on the financial document please sign above)

   Relationship to Applicant

  Date

Print Name

Telephone Number (Include Country Code and City Code)
Mailing Address                                                                                                                                 City                                       Country
APPLICANT'S CERTIFICATION: I certify that the information provided on this application is accurate and I understand that all the required credentials must be submitted before an admission decision may be made. If applying for conditional admission to the University I accept complete responsibility for requesting that official transcripts of record be forwarded directly to the University from each school attended, whether credit was earned or not, and I fully understand that these transcripts are not returnable and cannot be reproduced. Furthermore, I agree to abide by all the rules and regulations of the University of Nevada, Reno. I authorize IELC to release academic information to my parent or guardian/sponsor.

___________________________________________________________________________________________________

APPLICANT'S SIGNATURE                                                                                                                     Date

 

 

 

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