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Teacher Education (TE)
Intensive English Language Program (IELP)

IELP Application Form

Please complete the entire application.

Background information
I want to start studying during the:
Your name as it appears on your passport
First Name
Middle Initial
Last (Family) Name
Permanent Address (in your country)
Street 1
Street 2
City
Postal Code
Country
Permanent telephone number, fax number and email
Home Phone
Home Fax
Email
Current U.S. Address (if available)
U.S. Street 1
U.S. Street 2
City
State
ZIP Code
Personal Information
Country of Birth
 
Country of Citizenship (Passport Issuance)

 
Native Language
Gender
Date of Birth (MMDDYYYY)
(IELP students must be at least 18 years of age)
Education Information
Did you graduate from High School?

If you are already in the U.S., what is your visa status?


Alien Registration Number
Do you need an I-20 document to request a student visa? Students requesting an I-20 must show financial support.


Are you transferring from another school in the USA? If yes, please provide name and address.


Name of School
School Address
Dates of Attendance (MMYYYY)
From:   To:
Do you want to live on campus? (Students living on campus must be at least 17 years of age.)


Please give the name and contact information in case of emergency (friend or family preferably in the United States)


How did you learn about the Intensive English Language Program at Cleveland State University?


If other, please explain.


Translated Facts Sheets
Fact Sheet in Spanish
Fact Sheet in Korean
Fact Sheet in Japanese
Fact Sheet in Chinese
Fact Sheet in Arabic

Contact

Mailing Address
Cleveland State University
College of Education and Human Services
ESL Program
2121 Euclid Avenue
Julka Hall 314
Cleveland, OH 44115-2214

Campus Location
2485 Euclid Avenue
Julka Hall 314
Phone: 216-687-4600
Fax: 216-687-5379
Email: esl@csuohio.edu

Director ESL Program
Intensive English Language Program
Michele S. Bowman,Ph.D.
Phone: 216-875-9669
Email: m.s.bowman@csuohio.edu



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