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1. Print out, complete and return this form to the Center you wish to attend.
2. Please enclose the $95 application fee as well as all other applicable fees and documents.
3. Use the prepayment agreement form to pay by credit card or to notify us of a bank transfer.
Personal Information

[ ] Male   [ ] Female
Last (Family) Name: ___________________________________________________________
First Name: ___________________________________________________________
Address: ___________________________________________________________
___________________________________________________________
___________________________________________________________
Telephone: ___________________________________________________________
Fax: ___________________________________________________________
Date of Birth: ___________________________________________________________
Country of Birth: ___________________________________________________________
Country of Citizenship: ___________________________________________________________
Which Center do you wish to attend? [ ] Los Angeles [ ] Boston [ ] Santa Barbara [ ] Harvard Square
How did you hear about ELC? ___________________________________________________________
Email Address: ___________________________________________________________
GENERAL COURSES
[  ] Intensive English Program
30 lessons per week
$1075 per 4-week session
$  285 per week if less than four weeks
[  ] Semi-Intensive English Program
20 lessons per week
$885 per 4-week session
$230 per week if less than four weeks
[  ] Individual Intensive English Program
20 lessons per week
$4000 per 4-week session
$1000 per week if less than four weeks
[  ] Combination Course
20 group lessons per week plus
10 individual lessons per week
$2885 per 4-week session
$  730 per week if less than four weeks
[  ]

Part-time Course*
10 lessons per week
$450 per 4-week session
$125 per week if less than four weeks

* The part-time course does not qualify students for a student visa, homestay, residence or dormitory accommodations.

 

 

LONG-STAY PROGRAM








Intensive English Program
30 lessons per week
[
  ] 16-week course $4085
[  ] 20-week course $4945
[  ] 24-week course $5740
[  ] 28-week course $6622
[  ] 32-week course $7396
[  ] 36-week course $8127
[  ] 48-week course $10320

Please Note: In order to qualify for the Long-Stay Program prices, all course fees must be paid in advance. Course changes are not allowed and will cause the program fees to revert back to the standard prices.

SPECIALIZED COURSES
[  ] TOEFL Preparation
30 lessons per week
$1075 per 4-week session
$  285 per week if less than four weeks
[  ] TOEIC Preparation
20 group lessons of General English per week plus
10 individual lessons per week
$2885 per 4-week session
$  730 per week if less than four weeks
[  ] Cambridge First Certificate
(10-week session offered January 1 - March 9)
(Santa Barbara only)
30 lessons per week
$2950 per 10-week session
(includes exam which takes place March 10)
[  ] Cambridge First Certificate
(Los Angeles, Boston and Santa Barbara only)
30 lessons per week
$3245 per 11-week session
(includes exam which takes place in the 12th week)
[  ] Certificate in Advanced English
(Los Angeles & Boston & Santa Barbara only)
30 lessons per week
$3245 per 11-week session
(includes exam which takes place in the 12th week)
[  ] Teacher Training
(Boston only)
35 lessons per week
$1250 per 2-week session
[  ] English Plus
20 group lessons of General English per week plus PM specialized course
$1885 per 4-week session
Los Angeles:
[  ] English + Fitness
[  ] English + Tennis
Boston/Harvard Square:
[  ] English + Fitness
[  ] English + Music
Santa Barbara:
[  ] English + Scuba
[  ] English + Golf
EXECUTIVE COURSES
[  ] Intensive Executive English
(Boston only)
35 lessons per week
$1645 per 2-week session
[  ] Semi-Intensive Executive English
(Boston only)
20 lessons per week
$940 per 2-week session
[  ] Combination Executive English
20 group lessons of General English per week plus
15 individual lessons per week
$980 per week
[  ] Individual Executive English
35 lessons per week
$1750 per week
[  ] Combination Executive Plus
(Boston only)
20 group lessons of Executive English per week plus
15 individual lessons per week
$1220 per week

There is a non-refundable $95.00 application fee for all courses.

ELC Combination: Students who attend 2 or more ELC centers consecutively with a minimum 2-week stay per school will pay only one application fee and one first month's homestay fee.

 

DATES: Please check the dates you wish to attend.

GENERAL COURSES and
LONG-STAY PROGRAM


[  ] January 1 - January 26**
[  ] January 29 - February 23
[  ] February 26 - March 23
[  ] March 26 - April 20
[  ] April 23 - May 18
[  ] May 21 - June 15
[  ] June 18 - July 13
[  ] July 2 - July 27*
[  ] July 16 - August 10
[  ] July 30 - August 24 *
[  ] August 13 - September 7
[  ] September 10 - October 5
[  ] October 8 - November 2**
[  ] November 5 - November 30
[  ] December 3 - December 28
* Additional Summer Courses
** Classes begin on Tuesday (see School Holidays)

The General Courses and TOEFL Preparation Course may be taken for less than four weeks. If you are enrolling for less than four weeks or if your start date does not correspond to a scheduled start date, please write your start and finish dates below:

I will start on ___________
and finish on ___________

SPECIALIZED COURSES
TOEFL/TOEIC Preparation and English Plus Course
[  ] January 1 - January 26**
[  ] January 29 - February 23
[  ] February 26 - March 23
[  ] March 26 - April 20
[  ] April 23 - May 18
[  ] May 21 - June 15
[  ] June 18 - July 13
[  ] July 2 - July 27*
[  ] July 16 - August 10
[  ] July 30 - August 24**
[  ] August 13 - September 7
[  ] September 10 - October 5
[  ] October 8 - November 2**
[  ] November 5 - November 30
[  ] December 3 - December 28
   * Additional Summer Courses
  ** Classes begin on Tuesday      
(see School Holidays)         

Cambridge First Certificate
(Santa Barbara only)
[  ] January 1 - March 9**
(Exam given March 10)
(Los Angeles,Boston,and Santa Barbara only)
[  ] March 26 - June 8
[  ] September 24 - December 7
(Exam given during 12th week)

Certificate in Advanced English
(Los Angeles,Boston, and Santa Barbara only)
[  ] March 26 - June 8
[  ] September 24 - December 7
(Exam given during 12th week)

Teacher Training (Boston Only)
[  ] January 8 - January 19
[  ] July 9 - July 20
EXECUTIVE COURSES
Intensive, Semi-Intensive, and Combination Executive Plus
[  ] January 1 - January 12**
[  ] January 29 - February 9
[  ] February 26 - March 9
[  ] March 26 - April 6
[  ] April 23 - May 4
[  ] May 21 - June 1
[  ] June 18 - June 29
[  ] July 2 - July 13
[  ] July 16 - July 27
[  ] July 30 - August 10
[  ] August 13 - August 24
[  ] September 10 - September 21
[  ] October 8 - October 19**
[  ] November 5 - November 16
[  ] December 3 - December 14
** Classes begin Tuesday       
(see School Holidays)      

The Combination and Individual Executive Courses may begin on any Monday. Intensive and Semi-Intensive Executive Courses may begin on a non-scheduled date for a 25% surcharge. The Combination Executive Plus Course may begin on a non-scheduled date for a 10% surcharge.

If your course dates for the course you wish to attend are different from the above dates, please write your start and finish dates below:

I will start on ___________
and finish on ___________


2001 SCHOOL HOLIDAYS
(No classes)

All Schools
Jan. 1 New Year's Day    
Jan. 15 Martin Luther King Jr. Day    
Feb. 19 Presidents' Day    
April 16 Patriot's Day (Boston Only)  
May 28 Memorial Day  
July 4 Independence Day    
Sept. 3

Labor Day

Oct. 8 Columbus Day    
Nov. 22-23 Thanksgiving    
Dec. 24-25 Christmas    

 

ACCOMMODATIONS: Please select where you wish to stay.

Housing deposit for all accommodations except UCLA Dormitory and ELC Studio Apartments: $150. For all dormitories and residences, students must arrive the Saturday before their course begins and depart on the Saturday following their last day of classes.

Year-Round Accommodations

Homestay (All schools) First
4-week Session
Continuing
4-week Session
Per Week
(less than 4 weeks)
[  ]  Full board (single) $855 $760 $250
[  ]  Half board (single) $795 $695 $235
[  ]  Half board (shared)* $610 $520 $175
[  ]  Bed & Breakfast (single) $665 $575 $200
*Half Board Shared is available only in the following case: two students enroll together; arrive on the same date, depart on the same date, and share a room together.
BOSTON AND HARVARD SQUARE
ELC Studio Apartments
[  ]  Single $1395 $1195 $395
In order to confirm an ELC Studio Apartment, a deposit of $395 must be prepaid. A full refund will be given if cancellation is received more than 21 days before arrival.
International Guest House
[  ] Shared with meals
         (14 Meals/Week)
$1155 $1050 see below*
* One week $475, Two weeks $860, Three weeks $995. The continuing rate will not be pro-rated (e.g. 5 weeks equals $1155 + $475).
There is a refundable $150 key/damage deposit for the studios and International Guest House, which is payable upon arrival and refundable upon departure.

SANTA BARBARA
           

Santa Barbara Beach Hotel
1 Week
2 Weeks
3 Weeks
4 Weeks
Cont./
Week
Cont./
4 Weeks
[  ] Single $575 $1150 $1600 $1650 $394 $1575
[  ] Shared* $300 $  600 $  825 $  850 $206 $  825
[  ] Breakfast Supplement $ 63 $ 126 $ 189 $ 252 $ 63 $ 252
*Shared rooms may be booked by individual students from June 30 to August 25 only. From January 1 to June 30, and August 26 to December 31, only 2 students arriving and departing together on the same date can book a shared room.

City Center Hotel (Available year-round except from June 1 - September 7)
[  ] Single $275 $525 $725 $745 $205 $695
[  ] Mini-Breakfast Supplement $  20 $  40 $  60 $  80 $  20 $  80

Beachside Apartments & Suites (Available year-round except from June 1 - September 7)
[  ] 1 Bed: $1300 - $1500/month    [  ] 2 Beds: $1400 - $1800/month    [  ] 3 Beds: $1500 - $1825/month
(Mini-breakfast included)


Additional Summer Accommodations

Boston and Harvard Square

   

Emerson College Dormitory (Available July 16 - August 18)
 
 
1 Week
2 Weeks
3 Weeks
4 Weeks
Cont./
Week
 
[  ] Single*
$395
$790
$1185
$1395
$320
 
[  ] Shared*
$350
$700
$1050
$1250
$295
 
[  ] Dinners
$60
$120
$180
$240
$60
 
* Breakfast is included            

Beacon Inn Guest House (Available August 11 - August 25)
   
[  ] Double $350 $700 - - -  
Additional summer accommodations are available; please contact ELC Boston for details.

Los Angeles

UCLA Summer Campus Program (Available June 30 - August 25)
[  ] Single $609 per week             [  ] Shared; $371 per week (Minimum 14-night stay; 14 meals/week)
In order to confirm UCLA Dormitory accommodations, all dormitory fees must be prepaid.
A refund of 50% will be given for accommodations if cancellation is received prior to June 1. After June 1, no refund will be given.

Santa Barbara
Private College Dormitory (Available June 30 - August 25)
[  ] Shared: $215 per week (minimum 14-night stay; breakfast included)
Optional dinner plan available

OTHER INFORMATION: Please mark a box in each category.

Airport Transfers

[  ] I would  [  ] I would not like an airport transfer upon arrival.

Boston, Harvard Square and Los Angeles
The airport pick-up fee is $97.

Santa Barbara
[  ] Transfer from Santa Barbara Airport: $75
[  ] Airbus transfer from Los Angeles International Airport: $34
        Transfer by airport bus to Santa Barbara, no greeting
[  ] VIP transfer from Los Angeles International Airport: $150
        Los Angeles greeting and door-to-door transfer to accommodation in Santa Barbara

Health Insurance
[  ] I would like to get information about health insurance from ELC.
[  ] I would not like to get health insurance through ELC.

Courier Fee
If requested, ELC can send an I-20 via express courier for a fee of $50. There is also a $50 courier fee to send an I-20 if the I-20 request is received less than 2 weeks before the course start date.


Student Visa Information
[  ] Yes, I am enrolling in a full-time program of 20 lessons or more per week. I have submitted the required documentation and I would like to receive my I-20 form.
[  ] No, I do not wish to receive an I-20 form.

Financial & Health Statement
I have read and fully understand the costs, conditions, refund policy, health insurance and student visa information as outlined in the ELC brochure. I accept full financial responsibility for the time I study at ELC. I authorize ELC to take appropriate medical action in case of illness and/or injury, and I understand that I am responsible for all medical expenses incurred.

Refund Policy
For any cancellation ELC receives before the first day of the session, refunds can be made for the first session and any continuing session for which a student has enrolled. If cancellation is not received before the first day of class, tuition and accommodation costs for the first session are nonrefundable. (Exceptions to this refund policy are: the $150 housing deposit is refundable if the conditions on the accommodations page have been met; the prepayment for UCLA dorms is refundable according to the conditions below; the $95 application fee is not refundable.)

Students enrolling in ELC Los Angeles or ELC Santa Barbara, please request a catalog for refund and other policies.

_____________________________________________
Signature of Student

_____________________________________________
Signature of Sponsor
(If student is under 21 years old)

_____________________________________________
Date

 

 

 

 

ELC Los Angeles
10850 Wilshire Blvd., Suite 210
Los Angeles, California 90024 USA
Phone: (310) 470-3019 Fax: (310) 470-6733
e-mail: ELCLA@elcusa.com
ELC Santa Barbara
510 State Street
Santa Barbara, California 93101 USA
Phone: (805) 730-0040 Fax: (805) 730-9144
e-mail: ELCSB@elcusa.com
ELC Boston
867 Boylston Street
Boston, Massachusetts 02116 USA
Phone: (617) 536-9788 Fax: (617) 536-5789
e-mail: ELCBOSTON@elcusa.com
ELC Harvard Square
12 Plympton Street
Cambridge, Massachusetts 02138 USA
Phone: (617) 576-7454 Fax: (617) 576-2026
e-mail: ELCHSQ@elcusa.com

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