Admissions Inquiry
ECI English Language Program

Please print the form and email it to eci@ionet.net since we are experiencing some issues with receiving this form. You can always print the student application that is on the website; complete it and email it to us. You can always call us at 469-872-0069

  Personal Information


Name:

                     Family Name                          Given Name(s)

Name as written on your passport:

Current Address:

Permanent Address (if different):

Telephone Number:

   Include country and city code

Fax Number:

   Include country and city code

E-mail Address:

Date of Birth:    / /
                              Day        Month        Year

Sex:   Male         Female

Country of Birth:

Country of Citizenship:

Native Language:

How long have you studied English?

What is your current English level? (Select one)
Novice                       Beginner     Low Intermediate
High Intermediate    Advanced    High Advanced

 Emergency Contact
    (A family member or friend)


Name:

                     Family Name                          Given Name

Relationship to Student:

Telephone Number:

   Include country and city code

Address:

  Student and Visa Information


Are you now in the United States? Yes      No

If yes, when did you enter?
Month:     Year:

What type of visa do you hold?

If no, when will you enter?
Month:     Year:

Why do you want to study English in the United States of America?

How many sessions do you want to study at ECI ELP?

When do you want to start class? (Each ECI session is 4 weeks long)

Program Type for Internationals (Student Visa)
Intensive (25 academic hours, including electives)

Once you have submitted your information, please click here.