CENTER FOR ENGLISH LANGUAGE AND AMERICAN CULTURE

Application Form

Personal Information

IMPORTANT! USE ENGLISH CHARACTERS ONLY.
Enter all biographical information (name, gender, birthdate) exactly as listed on your PASSPORT!

1. NAME(S)
* Last/Family Name(s)

* First/Given Name (s)

    Middle Name (s)


* 2. GENDER
Female Male


* 3. DATE OF BIRTH:

Month: Day: Year:


* 4. COUNTRY OF BIRTH:

* 5.COUNTRY OF CITIZENSHIP:

* 6.COUNTRY OF LEGAL PERMANENT RESIDENCE:


7. 9-DIGIT UNM ID (if available)

8. PERMANENT ADDRESS IN HOME COUNTRY:
* Street Address

* City

   State/Province 

   Postal Code


* 9. CONTACT INFORMATION:
   Student Home Telephone:

   Student E-mail:

Application Form

* 1. I AM APPLYING FOR:
CELAC Admission


* 2. THIS APPLICATION IS FOR THE CELAC SEMESTER BEGINNING IN (PLEASE INDICATE YEAR HOW MANY SEMESTERS): CELAC will issue an I-20 for the time indicated below:

Year: 

Fall (16 weeks)
Spring (16 weeks)
Summer (8 weeks)
Summer (4 weeks -- June only)
One year


* 3. YOU WILL BE
Full-time student (4 classes)
Part-time (for non F-1 visa holders)

* How many classes are you going to take?


* 4. CHECK IF YOU WOULD LIKE US TO SEND BACK ALL ORIGINAL SCHOOL DOCUMENTS:


* 5. HOW DID YOU HEAR ABOUT CELAC:
Family or Friend
Internet Advertising
Internet Search
Magazine Advertisement
CELAC Website
Agent
Recruitment Fair
Other


* 6. FOR HOUSING INFORMATION:
Send Dormitory Information
I Will Arrange My Own Housing

Immigration Status Information

* 1. ARE YOU A U.S. PERMANENT RESIDENT OR CITIZEN?

Yes

No

* Are you applying for a F-1 visa?
No
Yes

Please, indicate the source of funds (please, select ALL available sources)
Personal (Verification type, no older than 6 months: A current bank statement)

* Amount Available in U.S. Dollars


Family/Relative (A current bank statement and letter from family member)

* Amount Available in U.S. Dollars:

* Name of Sponsor:

* Relationship to Applicant:

Address:
Street
City
Country
Postal Code
* Phone:
* E-mail:


Scholarship (Verification type, no older than 6 months: A current bank statement and letter from scholarship member)

* Amount Available in U.S. Dollars:

* Name of Sponsor:

Address:
Street
City
Country
Postal Code
* Phone:
* E-mail:


Other (A current bank statement and letter from sponsor)

* Amount Available in U.S. Dollars:

* Name of Sponsor:

Address:
Street
City
Country
Postal Code
* Phone:
* E-mail:

Please, attach copy of the bank statement (not older than six months), and/or letter of sponsorship in one document


* 2.WILL YOU BE ACCOMPANIED BY A SPOUSE AND/OR CHILD/REN?

No
Yes

Will you need child care during your studies? (Child care is not guaranteed and you may be responsible to pay an additional fee)

Yes
No

* List dependents who will be applying for F-2 Visa and traveling with you. Include a copy of passport photo page for each dependent.

  1. Spouse/Child Name as in Passport:
* Last/Family Name(s)

* First/Given Name (s)

    Middle Name (s)

* 2. Date of Birth: Month: Day: Year:

* 3. Country of Birth:

* 4.Country of Citizenship:

* 5. Gender
Female
Male

* 6. Relationship

* 7. Please, include a copy of passport photo page this dependent

Do You Want to Add Another Dependent?

Yes No

  1. Spouse/Child Name as in Passport:
* Last/Family Name(s)

* First/Given Name (s)

    Middle Name (s)

* 2. Date of Birth: Month: Day: Year:

* 3. Country of Birth:

* 4.Country of Citizenship:

* 5. Gender
Female
Male

* 6. Relationship

* 7. Please, include a copy of passport photo page this dependent

Do You Want to Add Another Dependent?

Yes No

  1. Spouse/Child Name as in Passport:
* Last/Family Name(s)

* First/Given Name (s)

    Middle Name (s)

* 2. Date of Birth: Month: Day: Year:

* 3. Country of Birth:

* 4. Country of Citizenship:

* 5. Gender
Female
Male

* 6. Relationship

* 7. Please, include a copy of passport photo page this dependent



* 3. ARE YOU CURRENTLY IN THE U.S.?
Yes

* What is Your Current Immigration status:


No


* 4. ARE YOU TRANSFERRING FROM ANOTHER SCHOOL IN THE U.S.?
Yes

* University Name:

* University Phone:

* Current US Address:

* Please enclose:

Copy of your current I-20


F-1 visa from your passport


No

Education

* 1. I have a high school diploma:
Yes
No


* 2. I have taken of English


* 3. My knowledge of English is:
Low-Intermediate
Intermediate
Advanced
TOEFL or IELTS Score (if applicable):


* 4. Do you plan to study at UNM after completing CELAC?
Yes

*Please, select the degree level you want to pursue:

Undergraduate program
Graduate program
Do not know

* Please, select area of studies you are interested in:

No


* 5. Do you plan to study at another university in the U.S. after completing CELAC?
Yes
No

Documents

* Please enclose:

Copy of your passport


Copy of your original or certified copy of High School or College transcripts AND certified English translations (if original transcripts are not in English OR Spanish) IN ONE DOCUMENT


Pay $50 non-refundable application fee, print receipt of payment (pay on-line by credit card from CELAC website, or by U.S. bank personal check, or international money order made payable to "University of New Mexico"), and attach copy here


Copy of your original or certified copy of High School or College diploma AND certified English translations (if original diploma are not in English OR Spanish) IN ONE DOCUMENT


Statement of Student

* I certify that all the information given in this application is complete and accurate to the best of my knowledge.