Texas Intensive English Program - [University Express Application For Admission]

University Express Application For Admission

Use this form to apply for the University Express Program. Do not use this form to apply for the TIEP Intensive English Programs.

A. FOR WHICH SESSIONS ARE YOU APPLYING?

Please select the sessions in which you plan to study in University Express.

	Session	Weeks	Registration Dates	Session Dates	Tuition & Fees
	(click to clear Summer session selection)
	Summer 2012	10	May 24	May 29 - Aug. 3	$5390
	(click to clear Fall session selections)
	Fall 2012	15	Aug. 29 - 30	Sept. 4 - Dec. 13	$8450
	Fall 2012	8	Oct. 17	Oct. 22 - Dec. 13	$4590
	(click to clear Spring session selections)
	Spring 2013	16	Jan. 09 - Jan. 10	Jan. 14 - May 14	$8450
(Spring Break: March 11 - 26)
	Spring 2013	8	Mar. 25	Mar. 27 - May 14	$4590

CALENDAR / TUITION & FEES

Tuition and fees are subject to change.
Housing, food, and medical insurance are not included. For total estimated expenses, click here.
Depending on enrollment, students who register for the Spring 8-week or Fall 8-week sessions may be welcomed into ongoing classes at the appropriate level.

TUITION - FEES INCLUDE:

Tuition for all instruction, including tutorials
Textbooks
Immigration Counseling
Assistance with housing arrangments
Classroom materials
Orientation Program
Placement Testing
Academic Advising
University Placement Service

University course auditing
Arrival and settling-in assistance, including airport pickup
Enrichment Activities
Certificate
Institutional TOEFL
Computer Lab with e-mail and Internet access
Wireless Internet Access
Photo ID Card

APPLICATION FEE

A $95 non-refundable, non-transferable application fee is required to complete your application. The application fee is valid for 12 months.

MEDICAL INSURANCE

All students with F-1 and J-1 visas must either show proof of medical insurance or purchase a plan at registration.

REFUND POLICY

FEES
The University Express application fee and express mail fee are neither refundable nor transferable. The University Express application fee is deferrable for one year.
PREPAID TUITION
Students who prepay University Express tuition in full and are unable to enter the United States and enroll in University Express for the session(s) for which they have prepaid will receive a full refund less a $100 cancellation fee. The refund request must be received in writing no later than the tenth (10th) class day or the student will forfeit all prepaid tuition.
WITHDRAWAL FROM TIEP AFTER REGISTERING
To receive a refund after registering at TIEP, a student must officially withdraw.
- Notice of withdrawal must be presented in writing by completing a Request to Withdraw form. This form is available from the TIEP Student Services Administrator and the TIEP Director.
- Students who withdraw before classes begin will receive a full refund, less a $150 cancellation fee.
- Students who withdraw after classes begin will receive a partial refund according to the schedule listed below. The refund will depend on when the withdrawal is requested and approved and on the length of the enrollment period. In the case of a Deferred Payment Plan, refunds are calculated on the full amount of tuition owed for the session, including fees.

1. WITHDRAWAL REQUESTED AND APPROVED	2. AMOUNT OF REFUND, BY ENROLLMENT PERIOD
	8 weeks	9 - 16 weeks
Before classes begin	100% - $150 cancellation fee	100% - $150 cancellation fee
During class days 1 – 5	50%	75%
During class days 6 – 10	0%	50%
After the 10th class day	0%	0%

B. PERSONAL INFORMATION * (required fields):

Family Name*:
First Name*:
Date of Birth*:	19
Gender*:	Male Female
Country of Birth*:
Country of Citizenship*:
Home Address (Outside the U.S.A.) Include postal code if applicable.
Number & Street, Apartment Number*:
City & State/Province*:
Country & Postal Code*:
Mailing Address (if different from Home Address Outside the U.S.A.) Include postal code if applicable.
Number & Street, Apartment Number:
City & State/Province:
Country & Postal Code:

Telephone*:
Fax:
Email*:
What is your highest educational degree or diploma?
	Year:
What is your educational objective in the United States?*

Have you studied at the Texas Intensive English Program or in the University Express Program before?
	Yes No
Do you have any known limitations or disabilities that may impede your ability to participate fully in the program?
	Yes No
If yes, explain in writing:

C. VISA INFORMATION * (required fields):

Do you wish to receive an I-20 A-B?*	Yes No
Do you have dependents who will need an I-20 A-B?*	Yes No
Are you presently in the United States?*	Yes No
If yes, do you have an F-1 visa?	Yes No
If yes, what is the name of the educational institution in which you are or were previously enrolled?

D. Do you want your I-20 sent by Express Mail for $55? *(if I-20 is requested)

If you select "Yes", you must include your Telephone number in Section B., above.
Yes No

E. OPTIONAL SERVICES

The following services are available. For more information and to apply, please see the links below.
Assistance with Housing Arrangements: Dormitories and Apartments
Airport Pickup

F. FINANCIAL INFORMATION

Indicate the person or organization responsible for your expenses during your study in University Express:

If other, please specify:
Name and address of person or organization responsible for your expenses:
Name:
Address Line 1:
Address Line 2:
Address Line 3:
Telephone:
Fax:
Email Address:
Remember: If you are requesting an I-20, an original bank statement, a letter from a financial institution, or a letter from your sponsoring organization should confirm that you have sufficient funds to pay for all educational and living expenses while you are in the United States.

G. CERTIFICATION * (required fields):

Before submitting this form, please read and select the box next to each of the statements below:
	I have carefully read this form and completed it personally.*
	I am able to pay for all educational and living expenses.*
	I agree to pay all tuition and fees for the University Express Program at registration.*
	I have read and agree to the University Express refund policy.*
	I do not have any physical limitations that would impede my ability to participate fully in the program.*
	I understand that emergency contact information is required in case I become incapacitated. I agree to provide contact information for someone who is legally responsible prior to registration.*
	I certify that all information on this application form and on the financial statement is true and correct to the best of my knowledge.*
IF FORM IS COMPLETED BY ANOTHER PERSON:
	I have explained the contents of this form to the applicant and have prepared the information at his/her request. I certify that all the information is true and correct to the best of my knowledge.

Name:
Address Line 1:
Address Line 2:
Address Line 3:
Telephone:
Fax:
Email Address:

H. TO COMPLETE YOUR APPLICATION, PLEASE DO THE FOLLOWING:

Pay a $95 non-refundable, non-transferrable application fee, plus, if requested, the $55 Express Mail fee.

Send a bank statement, a letter of financial guarantee, or a letter from your sponsoring organization and a photocopy of passport identification page for applicant and dependents to the following address:

University Express
1103 West 24th Street
Austin, TX
78705-4603
U.S.A.
Fax: (512) 322-0592
Send an official transcript for high school and all college or university classes, with official translation into English.

If this form is completed by a person other than the applicant, print out this form, have it signed by the preparer and by the applicant, and fax, mail, or e-mail a scanned copy of the signed form to University Express at the address above.

___________________________________________ (Signature of preparer)

___________________________________________ (Date)

___________________________________________ (Signature of applicant)

___________________________________________ (Date)

OR:

Submit this application form.

By clicking on the "Submit" button below and submitting this application electronically, you are certifying that all of the information you are providing is true and correct to the best of your knowledge.

How did you find out about our program?