Zoni Language Centers - Registration From Page in English

Student Application Form

Please fill out the application form below. If you need assistance, please contact one of our student service representatives at: Manhattan Campus: +01 (212) 736 9000, New Jersey Campus: +01 (201) 392 0900, Queens Campus: +01 (718) 565 9400, Miami Beach Campus: +01 (305) 673 8760. Thank you.

PART I - Biographical Data

Name:

Last *

Middle

First *

Gender *

Male
Female

Date of Birth
(mm/dd/yyyy)

Foreign Address:

Street Address *
City *
State/Region *
ZIP/Postal Code
Country *
Foreign Phone Number *
E-Mail Address *

U.S. Address:

Street Address *
City *
State *
ZIP/Postal Code *

Home Phone Number *

Mobile Phone Number

Others:

Country of Birth

Country of Citizenship

Country of Residency

PART II - Admissions Data

Choose a Campus

Manhattan Queens
New Jersey Miami Beach

Application Status for Manhattan, Queens and New Jersey

Premium Intensive-IEP (Full Time)
ESL Program (Full Time)
ESL Program (Part Time)

Miami Programs

Premium Intensive-IEP (Full Time)
Semi Intensive / Holiday Program
Junior Program

I20 Purpose

Initial Attendance
Change of Status
Transfer
Reinstatement
Other

Please Indicate the date on which you will start your classes (mm/dd/yyyy)

Have you previously studied at Zoni?	Yes No

How long are you going to study at Zoni?

Do you want us to help you find accommodations?	Yes No

Do you want us to arrange airport pick up?	Yes No

If yes please write the name of the airport

Sponsor Information

Last Name

First Name

Street Address
City
State
ZIP/Postal Code
Country

Phone Number
eMail Address
Relation to the Student

PART III - Visa Requirement Data

You must have a passport valid for al least 6 months.

Mail Service Request

Mail Service Request

Yes, I would like my I-20 form to be sent to my home address. I understand that a mailing fee must be paid before my documents can be sent.
No, please hold my I-20 form, which will be claimed by my relative, representative or by me.

Dependents Info

Are you including your children and spouse as dependents (F-2 status holders)? If yes, please complete Part IV - Dependents Information section otherwise skip to Part V - Educational Data
Yes
No

PART IV- Dependents Information Sheet

Dependent 1

Last Name

First Name

Gender

Male
Female

Date of Birth
(mm/dd/yyyy)

Nationality
Country of Birth
Relationship to the Student

Dependent 2

Last Name

First Name

Gender

Male
Female

Date of Birth
(mm/dd/yyyy)

Nationality
Country of Birth
Relationship to the Student

PART V - Educational Data

Educational Data

Primary School
High School
University/College
Graduate School

Emergency Contact

Name

Address
City
State
ZIP/Postal Code
Country

Phone Number

Relation With Student

Note:

Submitting this application does not guarantee your admission to Zoni. All required documentation has to be submitted along with this form. Along with this application, the student has to pay a non-refundable US$100.00 registration fee.

SIGNATURE

I certify that the information supplied on this application is complete and correct to the best of my knowledge. I agree to abide by the rules and regulations of the school as set forth in the Zoni Language Centers' catalog.

Signature
Date (mm/dd/yyyy)

* required field