AEI Applications MUST be submitted with ALL
supporting documents and fees.
Incomplete applications may be DENIED.
AMERICAN ENGLISH INSTITUTE (AEI)
California State University, Fresno
APPLICATION
C: SS Application w 8 weeks 10 02 14
THIS SECTION IS FOR AEI OFFICE USE ONLY
_______________
Date Received
_______________
Application Fee
_______________
AEI ID #
_________________
Receipt #
___ Approved
___ Not Approved
___ TR Form Received
___ Defer to __________
SESSION YOU ARE APPLYING FOR
Please refer to the Session and Fee Schedule. Please check one only.
SPRING
SUMMER
 Early Spring (8 weeks)
 Late Spring (8 weeks)
 Early and Late Spring
FALL
 SU (8 weeks)
2 0 ___ ___
(Year)
(16 weeks)
 Early Fall (8 weeks)
 Late Fall (8 weeks)
 Early and Late Fall
Given/first name
Country of birth
Native language
Age
_________ /______ / _______
Month
Day
Year
______
Last name (as on passport)
___ Pick up by: ______________
Date: __________________
#5 TEST SCORES
Highest TOEFL score: _____________
Highest IELTS score: _____________
Date of test: ___________________
Date of test: ___________________


Male
Female
I plan to study at a U.S. college or university.
If yes, what major field do you plan to study?


Single
Married
NO
If yes, what degree do you plan to complete?
 Undergraduate (BA or BS degree)  Graduate (MA or MS degree)
Have you ever applied to California State University, Fresno? YES NO
If yes, what date did you apply? ______________________________________
 YES  NO If yes, how many? _____
Given/first name
YES
Major field of study: _______________________________________________
(Example: Business, Engineering, Agriculture)
#2 DEPENDENT’S INFORMATION
Will you be bringing dependents?
___________________________
SEVIS ID #
#6 FUTURE STUDY PLANS
Full legal family/last name (as on passport)
Date of birth
___ Mail to: __________________
Date: __________________
(16 weeks)
#1 PERSONAL INFORMATION
Country of citizenship
___________________________
Student (PeopleSoft) ID #
If yes, what is your student ID#? ______________________________________
Relationship
#7 ACADEMIC INFORMATION
Last name (as on passport)
Given/first name
Relationship
Did you attend a college or university?
 YES  NO
If yes, name of university: ____________________________________________
#3 STUDENT’S PERMANENT ADDRESS (in your country)
________________________________________________________________________
________________________________________________________________________
City
Country
Postal (zip) code
_________________________
_________________
______________
Telephone
Country
Code
City Code
Number
Major field of study: _________________________________________________
 I did not graduate from a college or university.
 I received a BS/BA degree.
Date graduated: ____________________
 I received a MA/MS degree.
Date graduated: ____________________
#8 VISA INFORMATION
Do you now have a valid visa?
 YES  NO If yes, what kind? ________
Home phone
#9 TRANSFER or WILL-BE TRANSFER STUDENTS
Cell phone
If you are currently attending, have previously attended, or will attend an English
program in the U.S., please complete the following:
Email
#4 CURRENT MAILING ADDRESS (where you receive your mail)
________________________________________________________________________
________________________________________________________________________
City: _______________________________
State: ___________________________
Postal (zip) code: _____________________
Country: _________________________
Name of school: __________________________________________________
Address: ________________________________________________________
City: __________________________ State: _______ Zip code: __________
Phone: _______________________ Fax: ____________________________
Program start date: ______________ Program end date: _________________
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#10 ESTIMATED EXPENSES AND STATEMENT OF FINANCIAL SPONSORSHIP
ESTIMATED
EXPENSES
Estimated expenses for a 4-month period include AEI tuition, health insurance, student service
fee, books, and living expenses.
NOTE: Health insurance coverage purchased in your home country cannot be substituted for
the mandatory health insurance plan provided by the American English Institute.
Spring or Fall Session
$ 10,000.00
Summer Session
$ 7,000.00
I, the undersigned, guarantee without reservation to support the educational cost and living expenses of the applicant, including tuition
and fees, books and supplies, room and board (food), health insurance, medical or emergency expenses, travel, and personal expenses
while the applicant is enrolled in the American English Institute. As the applicant’s sponsor, my bank statement (in English) is being
submitted with this application. The bank statement shows a balance higher than the total estimated expenses and is dated within the last
six months.
Sponsor’s name
Sponsor’s relationship to applicant
Sponsor’s telephone number
Sponsor’s cell phone number
Sponsor’s address
_________________________________________________
_________________________________________________
City: _____________________________________________
Sponsor’s email address
State: ________________ Postal (zip) code: ____________
Country: _________________________
Sponsor’s signature
Date
#11 DECLARATION
I HAVE COMPLETED THIS APPLICATION ACCURATELY, AND I HAVE COMPLETED THE ENGLISH EVALUATION ON MY OWN. I CERTIFY THAT
THE STATEMENTS ON THIS APPLICATION FORM ARE CORRECT. BY SIGNING THIS APPLICATION, I UNDERSTAND:
A.
B.
C.
D.
E.
That any question answered incorrectly can result in the cancellation of my application or in my dismissal from the American English Institute (AEI).
Admission to the American English Institute (AEI) does not constitute admission to California State University, Fresno.
The application fee is non-refundable.
All fees paid on registration day are non-refundable.
If I do not follow the policies of the American English Institute (AEI), I will be dismissed from the program, I will not be permitted to apply for a future
session, and I will receive no refund.
APPLICATION INFORMATION RELEASE (Please choose one.)
 I give permission to the AEI to release information regarding my application to the contact below (if any).
 I do not give permission to the AEI to release information regarding my application to the contact below (if any).
Student signature: _______________________________________________
Date: _______________________________________
C: SS Application 10 02 2014
CONTACT INFORMATION: If you are submitting this application to the AEI on behalf of the applicant, please complete this section only.
I certify that this application is accurate and that the English Evaluation was completed by the applicant and in his/her own handwriting.
Contact name: ________________________________________
Address:
________________________________________
________________________________________
Relationship to applicant: ___________________________
Home phone number: ___________________________
Cell phone number:
___________________________
Email: ________________________________________________
Contact signature: _______________________________________
Date: ________________________________
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# 12 ENGLISH EVALUATION
Please complete this English Evaluation as part of your application. Mark your current English ability with an X.
The AEI offers levels of instruction from low-intermediate to advanced. NO BEGINNING LEVEL IS OFFERED AT THE AEI.
THIS SECTION MUST BE COMPLETED IN THE STUDENT’S OWN HANDWRITING.
C: SS Application 10 02 2014
1. What is your English ability in the subject areas below?
Weak
Moderate
Strong
Weak
Moderate
Strong
Vocabulary
Listening Comprehension
Writing
Grammar
Reading
Speaking
2. Some people prefer to get up early in the morning and start the day’s activities. Others prefer to get up later in the day and
study or work until late at night. Which do you prefer? Use specific reasons and examples to support your choice.
You must write one paragraph (more than five sentences).
#13 CHECKLIST OF ALL ITEMS TO BE SUBMITTED WITH YOUR APPLICATION.
PLEASE CHECK EACH ITEM THAT YOU COMPLETE.
1.  Application fee ($125 and non-refundable) payable to California State University, Fresno.
This fee includes the Express Mail delivery fee.
2.  Current Sponsor’s Bank Statement in English indicating that there are enough funds to cover
the estimated expenses OR For Admission Purpose Letter if you are a government-sponsored
student.
3.  English Evaluation (Section #12, Items 1 and 2 above).
4.  Passport: Clear copies of pages that show your name, passport number, issue date,
expiration date, birth date, and photograph.
5.  Dependent(s’) passport (if applicable): Clear copies of pages that show your dependent(s’)
name, passport number, issue date, expiration date, birth date, and photograph.
Please mail your application, fees,
and all supporting documents to:
Transfer students must also submit
the following documents:
6.  The completed AEI Eligibility
Transfer Form.
7.  A copy of the I-20 form issued by the
school from which you are transferring.
8.  A copy of your Admission/Departure
(I-94) card.
9.  A copy of your F-1 visa.
AMERICAN ENGLISH INSTITUTE (AEI)
California State University, Fresno
5048 N. Jackson Ave., M/S LS74
Lab School, Room 130
Fresno, CA 93740-8022 U.S.A.
APPLICATIONS DROPPED OFF AT THE AEI OFFICE MUST BE IN
A SEALED ENVELOPE WITH THE STUDENT’S FULL NAME.
INCOMPLETE APPLICATIONS MAY BE DENIED.
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