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ZONI Application Form0406

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 ZONI LANGUAGE CENTERS STUDENT APPLICATION FORM Please fill out the application below. If you need assistance, please contact one of our student representatives at: Manhattan Campus:+1 (212) 736 9000, New Jersey Campus:+1 (201) 392 0900, Queens Campus:+1 (718) 565 9400, Miami Beach +1 (305) 673- 8760. After completing the form either save it and email it as an attachment to info@zoni.com
or print it and mail it. Office Use Only Student ID# __________________ Contact date: _______________ Received by: _________________ Comments: ______________________________ ______________________________ Application Status: Qualified Denied Non-Qualified Approved PART I - Biographical Data Student Information: Suffix: (Mr. Ms. Jr., Etc.) Name: Last Middle First Gender: Male Female Date of Birth _______________
Foreign Address:
Street Line: Apt # Street Line: City, State, Zip: Country: U.S. Address:
Street Line: Apt # Street Line: City, State, Zip: Country: Foreign Tel. No.: Email address: Foreign Place of Business: Home telephone number: Personal Telephone Number: Residency:
Country of birth:
Country of Citizenship:
Country of Residency:
Sponsor Information Last Name: __________________
First Name: __________________
MI: ____
Number and Street: ________________________________________________
City: _____________________
State: ________
Zip Code: ________
Telephone: ________________
Fax: ______________
Email: __________________
Relationship to the student: ___________________________________________________________-
The following information is required in order to provide statistical data in compliance with federal and state non-discrimination requirements. Response is voluntary and the information will be kept confidential. Refusal to provide this information will not subject the applicant to any adverse treatment. Check the one race or ethnic group that best applies to you (optional): American Indian or Alaska Native White Other Hispanic Black Do not wish to respond Asian or Pacific Islander PART II - Admissions Data Choose a Campus:
Application Status:
Intended Workload:
Queens Intensive Full-Time Manhattan Semi Intensive Part-Time New Jersey Super Intensive Transfer Regular Specifications for preparing and issuing your I-20 Form: Please indicate the purpose of I-20 form. Initial Attendance Change of Status Transfer Reinstatement Other Please indicate the date on which you will start your
classes ___________ Note: The starting date must be on a Monday Do you want us to help you find accommodations? Yes No Would you like to be considered for the Zoni 1-year (48 weeks) certificate program? Yes No To obtain the Zoni 1-year (48 weeks) certificate, you must enroll in a full-time study program for 48 weeks and maintain
a high attendance rate. The Zoni certificate will not only certify your improved English skills; it will help open doors for
you around the world.
Have you previously applied to Zoni? Yes No Have you ever taken a Zoni course? Yes No Please indicate the number of years you have studied English. How long are you going to study at Zoni? _________ Your Agency’s name: PART III – Visa Requirements Data Passport Number: You must have a passport valid for at least 6 months. Students who are neither U.S. citizens nor permanent residents of the U.S. must complete the section below.
Are you currently residing in the U.S.? Yes No If yes, which visa do you hold? M-1 J-1 B-1/B-2 F-1 Other : Date of entry into the U.S. / / Visa Expiration Date: / / Passport Expiration Date: / / mm/dd/yyyy mm/dd/yyyy If you currently have F-1 Visa status, Name the institution that issued your I-20AB: INS admission number (Refer to your I-94 card) Current non-immigrant status (Refer to your I-94 card) SEVIS Number __________________________________ Mail Service Request Yes 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 No, please hold my I-20 form, which will be claimed by my relative, representative or by me. Are you including your children and spouse as dependents (F-2 status holders)? Yes No If Yes, please complete the Part IV- Dependents information sheet otherwise skip to Part V- Educational Data
PART IV – Dependents Information Sheet: Dependent I
Last Name: First Name: MI: Date of Birth: Sex: Female Male Nationality: Country of Birth: INS admission number (Refer to your I-94 card): Current non-immigrant status (Refer to your I-94 card): Passport Expiration Date: Relationship to the Student: Dependent 2
Last Name: First Name: MI: Date of Birth: Sex: Female Male Nationality: Country of Birth: INS admission number (Refer to your I-94 card): Current non-immigrant status (Refer to your I-94 card): Passport Expiration Date: Relationship to the Student: Dependent 3
Last Name: First Name: MI: Date of Birth: Sex: Female Male Nationality: Country of Birth: INS admission number (Refer to your I-94 card): Current non-immigrant status (Refer to your I-94 card): Passport Expiration Date: Relationship to the Student: Dependent 4
Last Name: First Name: MI: Date of Birth: Sex: Female Male Nationality: Country of Birth: INS admission number (Refer to your I-94 card): : Current non-immigrant status (Refer to your I-94 card): Passport Expiration Date: Relationship to the Student: PART V – Educational Data: Highest level of education completed: Primary School High School Undergraduate School Graduate School Associate Degree Please indicate the tests you have taken GRE GMAT TOEFL Business Experience/ Extra Curricular Activities (optional) List any business/work experience that supplements your academic background:
Firm and Location: Nature of Work: Dates From: To: List any business, professional and social organizations in which you have been active and any professional licenses that you hold: List any awards, honors, sports activities, clubs and organizations, you participate(d) in Parental Information Mother’s Name: __________________________________ Father’s Name: __________________________________ Address: _________________________________________ Address: _________________________________________ City, State and zip: ________________________________ City, State and zip: ________________________________ Phone: ___________________________________________ Phone: ___________________________________________ Occupation: _______________________________________ Occupation: _______________________________________ Do you have any relatives who have attended Zoni? Yes No If you have any siblings, please write their names: _________________________________________________________________ PART VI – Essay Please prepare an essay using any word processing application (Microsoft Word, Word Perfect, etc.) and attach it this application form while submitting. In writing your essay, please make sure the followings. Double-space your document Spell-check your document and proofread it carefully. Essay Topic:
What are your career goals, and how will your education at Zoni Language Centers support these goals? Note: Submitting this application does not guarantee your admission to Zoni. All required documentation must be submitted along with this form. CONDITIONS OF APPLICATION & 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 catalog of Zoni Language Centers’ catalog, with which I am familiar. SIGNATURE OF APPLICANT: ____________________________________________ DATE: ___________________________ Zoni Language Centers/ 22 West 34
th
Street – 6
th
Floor/ New York, NY 10001 
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maspanashvili
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