Contact Information
Please type name EXACTLY as shown on your passport.
Family Name:
*
First Name:
*
Middle Name:
*
Sex:
Male Female
Email Address:
*
Phone number:
*
FAX number:
*
Current Mailing Address
Current Mailing Address:
*
City:
*
State or Province:
*
Country:
*
Postal Code:
*
Permanent Address (in your home country)
Permanent Address:
*
City:
*
State or Province:
*
Country:
*
Postal Code:
*
How did you find out about us?
* a friend or family member
an advisor or counseling agent
Study USA web site
Embark.com web site
a Web search on my own
Other:
Get More Information
Send me brochures about:
American English Institute
University of Oregon Undergraduate programs
University of Oregon Graduate programs
General Information about Oregon
Registration Information
Term:
When do you want to begin to study at the AEI?
Summer 2008 (June 23 - August 29, 2008)
Fall 2008 (September 29 - December 5, 2008)
Winter 2009 (January 5 - March 13, 2009)
Spring 2009 (March 30 - June 5, 2009)
Summer 2009 (June 22 - August 28, 2009)
Have you ever applied to the AEI before?
Yes
No
How long do you plan to attend the AEI?
1 term (One term = 3 months)
2 terms
3 terms
One year or more
Personal Information
Date of Birth:
Month
01
02
03
04
05
06
07
08
09
10
11
12
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
Country of Citizenship:
Country of Birth:
Are you currently in the United States?
Yes
No
Visa Type:
If you are in the United States now, what type of visa do you have?
no visa now
F-1/F-2 Student
B-1/B-2 Visitor
M-1 Student
A-1/A-2 Diplomat
J-1/J-2 Exchange Visitor
(Click to change answer.)
Marital Status:
Single
Married
Will spouse accompany you?
Yes
No
If yes , please give us information for your spouse:
Will children accompany you?
Yes
No If yes , please list them below:
Education Information
Name of School:
List the most recent school you have attended (high school or higher education):
Location of School:
Graduation Date:
Degree:
Highest degree completed:
High School
Bachelor
Master's
Doctorate
(Click to change answer.)
Transfer Student Information
Name of School:
If you are transferring from another school in the United States, what is the name of that school?
Length of enrollment:
Location:
I-94 Number:
SEVIS Number:
Financial Statement
Instructions:
Indicate source(s) of your funds and
the amount of money. Send required documentation with Part 2 of the application.
Personal or Family Funds
Yes No
Guarantor
Yes No
Scholarship
Yes No
Other
Yes No
Application Fee
How would you like to pay the application fee?
Due: 65 US Dollars
Check
Money Order
Credit Card
(Click to change.)
Note: ONLY Visa and MasterCard credit cards accepted.
To pay by mail: please send payment (check or international money order) with Part 2 of the application via air mail to:
American English Institute
5212 University of Oregon
Eugene, OR USA 97403-5212
Submit Application
Submitting Form:
Click button to submit application:
After you submit Part 1, Part 2 will appear. Print out Part 2, complete and send to AEI by air mail.