½ Applicant’s Name Last: First: Middle: @ Date of Birth mm/dd/yy Male Female E-mail: Address Program Name Fall Semester Course Start Spring Semester Summer Term Social Security # - (optional) Telephone Mobile School or College City and Attended (From To) – Educational Background Please provide details of any disabilities or special educational needs, Health and medical any on-going illness or medical condition and its treatment, any special information requirements regarding health, diet or religion. Payment methods ❑ Remit the fee of US$100 (Non-Refundable Application Fee $10+ Tuition $90) by sending personal
Applicant’s Name Last: First: Middle: Date of Birth mm/dd/yy Male Female E-mail: @ Address Program Name Course Start Fall Semester Spring Semester Summer Term Social Security # (optional) - Telephone Mobile Educational Background School or College City and Attended (From – To) Health and medical information Please provide details of any disabilities or special educational needs, any on-going illness or medical condition and its treatment, any special requirements regarding health, diet or religion. ½ ❑ Payment methods Remit the fee of US$100 (Non-Refundable Application Fee $10+ Tuition $90) by sending personal