Check

Campus

Mclean

Fredericksburg
For levels 7-12

APPLICATION FORM
Full Name: ________________________________________________________________________________

Date of Birth (MM/DD/YEAR): _____________________ Country of Birth ______________________________

Country of Citizenship: ______________________________________________________________________

USA Contact Information

Address: __________________________________________________________________________________

City: _____________________________________ State: ________________ Zip Code: _______________

Phone Number: ____________________________ Email: _________________________________________

Permanent Contact Information (Home Country)

Home Country Address: ____________________________________________________________

City: ________________________ State/Province: ______________________________________________

Country: ______________________________ Postal Code: _________ Phone Number: _________________

Current Immigration Status in U.S. (if applicable): _______________________ Gender: ________________

Name of a friend or relative living in the U.S. (optional): ___________________________________________

Contact Information of friend or family (phone, email): ____________________________________________

Session Dates for which you are enrolling: _______________________________________________________

Length of time you plan to study at ILA: ________________________________________________________

How did you hear about ILA? _______________________________________________________________

Plans after completing your studies: __________________________________________________________

__________________________________________________________________________________________

1 | P a g e
8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu

How can ILA best serve you in the next session?

Specific Classes: ___________________________________________________________________________

Housing Assistance: _________________________________________________________________________

Medical Insurance: _________________________________________________________________________

Assistance with College Applications: __________________________________________________________

Test Preparation: IELTS □ TOEFL □ GRE/GMAT □ Other (please specify): ____________________________

Current Education Level: Some high school □ HS Diploma/GED □ Some College □

Bachelor’s □ Master’s □ PhD □ Other (please specify): ____________________________

Please be sure to submit the following documents with your application:

□ Copy of your Passport

□ Copy of your Visa (if you already have one)

□ Copies of your high school/college transcripts and diplomas

□ Statement of Financial Support

Any other questions, concerns, suggestions, or ways ILA can help?

Name: __________________________________________________________ Date: __________________

Signature: ________________________________________________________________________________

2 | P a g e
8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu

 Initial Student Agreement Form
Personal Information

Full Name:
Last First M.I.

Address in Home
Country:
Street Address Apartment/Unit #

City Country ZIP Code

Home Phone: Alternate Phone:

Email of student:

Date of Birth:

Session you are

applying for:

Program you are

applying for:

Please select one of the following, which best describes your status:

□ I am an international student and I want to apply for an F1 visa. I am not in the United States right now.
F1 visa. I am not in the United States right now.

□ I am an international student, I already have an F1 visa and am currently studying in the United States. I want to
transfer to ILA from my current school.

□ I am in the United States with a non-F1 visa. My current visa is a: ___________________________________.

□ I want to change my status to F1 student □ I want to keep my current visa
□ I am a United States citizen or Green Card Holder.

8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu
 F1 Visa Students & Transfers ONLY
How would you like to receive your I-20? Choose ONE.

□ Mail my I-20 to my home address (listed above)

□ Mail my I-20 to a different address:
Street Address

City Country ZIP Code

Primary Phone: Alternate Phone:

□ I authorize _____________________ to pick up my I-20 directly from ILA.

Your I-20 will automatically be prepared using this information. If any of this information is wrong or if you decided to change
how you want to receive your I-20, you must notify ILA as soon as possible, by emailing info@ila.edu. If you change this
information after your I-20 has been sent, you will be required to pay a postage fee for a new I-20. ($40 international, $25
domestic). You will be called or emailed when your I-20 is ready to be mailed or picked up.

By signing this Initial Student Agreement Form, I agree to the following conditions:

• I agree to study at the International Language Academy for a minimum of three sessions before I attempt to transfer
to another university or college. (If a student fails to stay enrolled for a minimum of three sessions, a $1000 penalty
will be applied. If a student is not granted their visa, their tuition will be refunded. The $150 application fee will not be
refunded).
• If I decide to study at a different school before I travel to the USA, I will not use an I-20 from ILA to enter the
USA. I acknowledge that I can enter the country only by using the I-20 from a college I plan to attend. (A
penalty of $1000 will be applied.)
• I agree to take an English language placement test before registering for any classes.
• I agree to attend ILA’s New Student Orientation session on the specified date before my first session starts.
• I agree to abide by SEVIS rules before I request any vacation time. I am aware I need to study for 1 year before
requesting any time off. After a vacation I am aware I must register for 1 session at ILA before transferring out.

Please note: ILA will only refund tuition deposits to the person/organization who made the original payment. Tuition should be
made directly to ILA. ILA does not authorize any third parties to collect tuition from students. The $150 application fee is non-
refundable.

Student Signature: ____________________________________________________________________________

Date: ________________________________________________________________________________________

8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu
  

Statement  of  Financial  Support  

Personal  Information  
Student’s  Full  
Name:  
     
 
Last   First   M.I.  
 

Sponsor’s  Information:  

Sponsor’s  Full  Name:    

     
Last   First   M.I.  
 

Sponsor’s  Address  
in  Home  Country:  
   
 
Street  Address   Apartment/Unit  #  
 

 
     
 
City   Country   ZIP  Code  
 

Phone  Number:    
 
 

Email  of  Sponsor:  

 
 

Occupation  of  
Sponsor:  
 
 

Please  note:  If  your  sponsor  is  a  company,  please  provide  a  sponsorship  letter  on  the  company  letterhead.  

Relationship  to  student:    

□  Myself      □    Family    □    Friend    

 

 
8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu
 
 Declaration  of  Student:  
 

I  have  read  the  estimated  expenses  for  international  students  and  I  understand  the  U.S.  Immigration  requires  
that  I  show  proof  to  the  International  Language  Academy  of  my  financial  ability  to  meet  these  expenses.  I  also  
understand  that  I  am  required  by  law  to  show  proof  of  financial  support  to  cover  at  least  my  first  year  of  study.  
In  addition,  I  must  provide  proof  that  adequate  funding  will  be  available  to  cover  subsequent  years  of  study.  I  
also  understand  that  if  I  cannot  meet  my  financial  obligations  to  the  university,  or  if  it  becomes  evident  that  I  
have  given  false  information  in  this  Statement  of  Financial  Support,  I  may  be  withdrawn  from  school.  I  have  read  
the  estimated  expenses  and  Cancellation  Refund  policy  for  international  students.  

*Do  you  plan  on  bringing  dependents?  (For  example,  your  spouse  or  children)   □  Yes,  how  many?  ____  □  No  
Student’s  Signature  _________________________________________________    Date:  ___________________  

Declaration  of  Sponsor:  

 

By  signing  this  form,  I  agree  to:  

• Sponsor  the  above  student  for  the  duration  of  his  or  her  program,  in  accordance  with  the  prices  listed  
on  Page  3  of  this  form.  
• If  the  student  is  bringing  dependents,  I  agree  to  provide  $3,000  for  the  first  dependent  and  $1,500  for  
each  additional  dependent.  

Sponsor’s  Signature:  ____________________________________________  Date:  _________________________  

Proof  of  Financial  Support  

 

A  recent  bank  statement(s)  in  the  name  of  the  sponsor,  listed  above,  must  also  be  provided  with  this  form.  The  
following  conditions  must  be  met:  

  1.  The  name  on  the  bank  statement  must  match  the  name  of  the  sponsor  stated  above.  

  2.  The  information  on  the  bank  statement  must  be  dated  within  6  months  of  the  intended  date  of  
enrollment.  

  3.  Proof  of  property  ownership  and  proof  of  employment  are  NOT  sufficient  evidence  of  fund  
availability.  

Please  Note:  The  bank  statement  will  need  to  show  at  least  the  minimum  amount  required  for  the  program,  as  
shown  on  Page  3.  If  an  applicant  has  more  than  one  sponsor,  a  bank  statement  and  a  Statement  of  Financial  
Support  Form  much  be  submitted  for  EACH  sponsor.  

 
 
8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu
 
Application  Cancellation  Refund  Policy:  

If  the  embassy  in  your  home  country  has  declined  your  visa  application  for  any  reason,  any  money  you  have  
deposited  with  us  will  be  refunded  excluding  the  application  and  postage  feeds.  Any  and  all  fees/charges  
incurred  will  be  paid  by  the  student.  

To  receive  a  refund,  the  applicant  must  do  the  following  (The  $150  Application  Fee  is  non-­‐refundable):  

Request  a  refund  by  email  at  info@ila.edu,  and  fax  us  an  Application  Cancellation  and  Refund  Request  Form  at  
+1  (703)  712-­‐8371.  ILA  will  only  refund  tuition  to  the  person/organization  who  made  the  original  payment.  
Please  note  that  the  refund  process  can  take  up  to  45  calendar  days.  

Estimated  Expenses  
 

For  International  Students  at  the  International  Language  Academy  of  Washington,  DC  on  an  F1  Student  visa  

Programs   Estimated  Tuition*   Living  Expenses   Health  Insurance   Total  

General  English   $7,300   $9,000   $1,500   $17,800  
Intensive  English   $11,700   $9,000   $1,500   $22,200  
 

Living  Expenses:  This  is  an  estimate  of  minimal  expenses  only.  It  is  advised  that  each  student  should  arrive  in  the  
United  States  with  at  least  $2,500  in  cash  to  cover  “settling-­‐in”  expenses.  

Health  Insurance:  This  is  required  at  the  International  Language  Academy.  ILA  provides  a  health  insurance  plan  
to  international  students.  

Tuition  and  Fees:  Subject  to  change  without  prior  notice.  Money  for  personal  expenses  (health  insurance,  living  
accommodations,  etc.)  is  not  included  in  tuition.  The  estimated  tuition  accounts  for  the  international  student  
enrollment  fee  ($150),  the  cost  of  books  and  materials  ($120),  and  tuition  for  two  semesters  –  the  equivalent  of  
8  sessions.  International  students  enrolled  in  ILA’s  General  English  Program  are  required  to  attend  a  minimum  of  
18  hours  of  classes  per  week  and  a  minimum  of  25  hours  per  week  for  those  enrolled  in  ILA’s  Intensive  English  
Program.  

Housing:  The  average  annual  living  expenses  (housing  and  food)  in  the  Washington,  DC  area  is  $9,000  per  
student.  These  estimated  expenses  are  so  a  single  student,  with  no  dependents  (spouse  or  children).  Those  
students  bringing  dependents  must  show  proof  of  having  an  additional  $3,000  per  year  for  the  first  dependent  
and  $1,500  per  year  for  each  additional  dependent.    

 
8000 Westpark Dr Suite 160, McLean Virginia 22012, USA Ÿ Tel: 703.712.8002 Ÿ Fax: 703.712. 8371 Ÿ email: info@ila.edu