ELLP Application:Loyola University Chicago

ELLP Application

PERSONAL INFORMATION
I am applying for: Summer 12 2012 Summer A 2012 Summer B 2012 Fall 2012
Salutation
First Name
Middle Name
Surname
Suffix
Gender	Female Male
Birth Date	(mm/dd/yyyy)

HOME COUNTRY ADDRESS (ADDRESS FOR I-20) (required)
Street 1
Street 2
City
State/Province
Zip/Postal Code
Country
Telephone
Cell Phone

E-mail Address
U.S. CONTACT INFORMATION (if any) (if different from above)
Street 1
Street 2
City
State
Zip Code
Telephone
Cell Phone

EDUCATION HISTORY
High-School History
Will you have graduated from high school or received your GED before the semester you are applying for?
College History
Please list the names and degrees of all colleges and ESL programs you have attended.
How long do you plan to study in the ESL Program?
ENGLISH LANGUAGE PROFICIENCY
What is your current English level?
What standard English test have you taken?
What was your score?
Explain why you want to study in the Loyola ESL Program and how it relates to your future degree goals. The writing must be your own, and should be approximately 1-2 paragraphs. MUST BE IN ENGLISH

DIGITAL SIGNATURE
I agree to pay the tuition, fees or other charges which are assessed in accordance with Loyola's published financial policies. This application cannot be processed if information is withheld or misinformation is given, or if the applicant's digital signature is missing. Instead of my written signature, typing my first name and last name in the boxes below indicates that the information in my application is complete, factually correct, honestly presented, and that I have read the above statement.
First Name
Last Name