English Language Institute Application
Step 1
Student Information
Student’s Name
LastFirstMiddle
Permanent AddressCityStatePostal CodeCountry of Citizenship
Country of Address
Country of Birth
Date of Birth (MM/DD/YYYY)
Email
/
/
r
Male
Phone Number
r
Female
Marital Status r Single r Separated r Married r Divorced
Are you a legal permanent resident of the U.S.? (If “yes,” please indicate your alien registration #) r Yes r No
Alien Registration #
Highest level of education completed
Will you need on-campus housing while enrolled in the English Language Institute (ELI)? Have you been accepted by a U.S. college or university? r
Yes
r
No
Are you planning to attend Liberty University after your English language training? If “Yes,” what program of study?
Step 2
Yes r
No
r
Yes
r
No
r
Undecided
(Separate application required for all other Liberty programs.)
Enrollment Information
Proposed Year of Entry 20______ r
Step 3
r
If “Yes,” where?
Summer Term
r
Fall Semester
r
Spring Semester
VISA Requirements
Do you need a student visa to attend ELI? (If yes, you must submit additional documents. See Step 5) If you already have a VISA, please complete
the following information: r B-1 (business) r B-2 (tourist) r J-1 (exchange visitor) r F-1 (student) r Other (please specify)
What is the expiration date of your current status?
/
/
MonthDayYear
Step 4
Background Information
Are you a Christian? r Yes r No If “Yes,” name of church you attend:
If “No,” what is your religious affiliation?
Denomination
Liberty University is a regionally accredited university which teaches a Christian worldview and promotes Christian values and ethics among its students. The university welcomes
international students from other faiths, but desires that they be aware of Liberty’s distinctive position before they apply. Please read the following:
Liberty students are expected to participate in the Christian activities of the campus community, including Convocation and all residence hall meetings. Liberty students are also required
to participate in community service, devoting a certain amount of time each semester to serving others.
Liberty students are required to follow the student code of conduct known as “The Liberty Way”. Violations of The Liberty Way can result in fines and possible dismissal from school, so it is
important that international students be aware of the code of conduct before submitting an application. Expected conduct of Liberty students includes:
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•
•
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Abstaining from tobacco in any form
Abstaining from alcohol or using illegal drugs in any form
Being in the residence hall at the required time each evening
Not entering a residence hall of the opposite gender
Using appropriate language
Abstaining from explicitly sexual material or movies
Attending Convocation during the week
Refraining from outward participation in distinctively non-Christian religious rituals or displaying distinctively non-Christian religious material on campus
Wearing appropriate clothing (see The Liberty Way for class dress code)
Abstaining from sex outside of marriage
Showing proper respect to fellow students, faculty, and staff
Respecting the Christian philosophy of the university and using the time at the university to better understand Christianity
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After reading the background information (Step 4), please answer the following questions:
1.
2.
3.
4.
5.
6.
Have you ever been dismissed from school for academic or disciplinary reasons?
Have you used alcohol, tobacco, or non-medical drugs during the past 12 months?
Have you ever been convicted of a crime?
Do you understand the Christian position of Liberty University?
Do you wish to study at a Christian university and responsibly participate in the life of the campus?
Do you intend to follow the code of conduct in The Liberty Way, which is summarized in Step 4?
r Yes
r Yes
r Yes
r Yes
r Yes
r Yes
r
r
r
r
r
r
No
No
No
No
No
No
If you answer “yes” to Questions 1-3, you must provide a brief explanation on a separate piece of paper, or by email.
Step 5
Other Requirements
$40 Application Fee – Required and nonrefundable.
Passport Photograph Page – Provide a clear copy of the photograph page from your passport. If you do not have a passport, provide a copy of
your National Identity Card, which includes a photograph. (Required only for students who plan to study on a student visa.)
Affidavit of Financial Support – This document includes a letter from your sponsor(s) and bank verification of your sponsor’s ability to provide
the funds for you. An affidavit form can be found at www.Liberty.edu/Affidavit. (Required only for students who plan to study on a student visa)
NOTE: Campus employment is generally not available for first-year students.
Step 6
Payment Information
Check/Money OrderCredit Card #Expiration DateAmount $
Step 7
Agreement
The candidate must read and sign the statement below before the admissions committee can consider this application
The undersigned agrees that:
1.
The university may take such investigation, as it deems proper in connection with this application, and will treat as confidential all information submitted herein or received by the university from any source including without limitation the applicant or his/her family. An applicant may review any information gathered.
2.
The provision concerning fixing the amount, adjustment on withdrawal or late arrival, and other terms of comprehensive fee payments as set forth in the university’s annual catalog are incorporated herein and are hereby accepted.
3.
An applicant applying for admission shall pay a $40 application fee. This application fee is nonrefundable and nontransferable. This fee cannot be applied towards other university charges. The application and its fee may be deferred for one academic year.
4.
The Liberty Way addresses academic and non-academic conduct and is an integral part of the Liberty community, which consists of individuals from diverse backgrounds and experiences dedicated to obtaining a superior education in fidelity to the Christian faith. Central to preserving this community is the personal commitment of students to conduct themselves in a manner that reflects the highest ideals of moral virtue and professionalism. To this end, The Liberty Way sets forth the disciplinary procedures that apply when misconduct by a student is alleged to have occurred. Students are charged with notice of and are bound by this code. All students shall agree to comply with the terms of the Liberty Way. A link to all of Liberty’s conduct policies will be provided upon acceptance to the university.
5.
I certify that all of the information given in this application is complete and accurate to the best of my knowledge.
The mission of Liberty University is to develop Christ-centered men and women with the values, knowledge, and skills essential to impact the
world. We expect that our students understand and respect our mission and purpose while enrolled at Liberty University.
Signature of ApplicantDate
Liberty University considers applicants for admission without regard to race, color, gender, national or ethnic origin, age, or disability.
Liberty University • 1971 University Boulevard • Lynchburg, Virginia 24515
(434) 592-4118 • Fax (434) 522-0340
Website: www.Liberty.edu/ELI • Email: international@Liberty.edu • Skype: Intlstu.liberty