Secure Individual Online Application

•Required

A. Personal Information

•Family name/Surname:
•Given/First name:
Birthdate:
Year Month Day
•Age on entry to U.S.A.:
•Citizenship:
•Birth Country:
How did you learn about The IDEAL School?:
•Age?:
less than 21 years of age
21 years of age or older
Student Home Phone:
Student FAX:
•Student E-mail:
•Address 1:
Address 2:
•City:
State/Province:
•Country:
•ZIP/Postal Code:

If less than 21 Years of Age:

Father:
Living
Deceased
Mother:
Living
Deceased
Check all that apply to you:
I live with my Father
I live with my Stepfather
I live with my Mother
I live with my Stepmother
Other:

Father

Family name/Surname:
Given/First name:

Mailing address, phone, and e-mail (if different)

Address 1:
Address 2:
City:
State/Province:
Country:
ZIP/Postal Code:
Home Phone:
FAX:
E-mail:

Mother

Family name/Surname:
Given/First name:

Mailing address, phone, and e-mail (if different)

Address 1:
Address 2:
City:
State/Province:
Country:
ZIP/Postal Code:
Home Phone:
FAX:
E-mail:

B. Health

List any medical conditions or allergies:
List any foods you do not eat:
•Do you agree to help keep The IDEAL School smoke-free by not smoking anywhere while studying at The IDEAL School?:
Yes
No

Health insurance is required for all students. At The IDEAL School, all students are covered by our high quality health insurance. This health insurance meets all the US government requirements.

C. Program

•What is your English ability?:
•Have you ever taken the TOEFL?:
Yes
No
If yes, what was your score?:
•What are your goals for coming to The IDEAL School?:
•Which program do you plan to attend?:

We will do our best to accommodate your desired start and end dates. However, there are a limited number of places available in The IDEAL School, so please be prepared to be flexible.

Desired Start Date:
Year Month Day
Desired End Date:
Year Month Day