CENTER FOR ENGLISH AS A SECOND LANGUAGE
FANER HALL – MAIL CODE 4518
1000 FANER DRIVE
CARBONDALE, ILLINOIS 62901
TELEPHONE: 618-453-2265 FAX: 618-453-6527
Center for English as a Second Language
APPLICATION FORM
Date today:
Name :
Email address:
(family name)
Date of birth:
(middle name)
(CESL applicants must be at least 18 years of age or have completed secondary school)
Country of birth:
Address:
(first name)
Country of Citizenship:
Gender:
Male /
Female
(Street Address),
(City),
NOTE: Agents must use the student’s
home address and email address. Failure
to do so will result in the rejection of this
application. You may enter the agency’s
email address in the “Agents” section on
the next page. Communication will be sent
to you. The I-20 will be mailed to the
address listed in the “I-20 Mailing Address
on the next page.
(State/Province)
(Country)
Postal Code
Telephone
(Student’s email address, REQUIRED)
Visa Information
Are you already in the USA?
Yes
No
If you are already in the USA, please indicate your visa type:
F1
F2
J1
Permanent Resident
US Citizen
Other:
Transfer
Are applying to transfer to CESL?
Yes
No
If yes, print the name of the school where you are currently enrolled
Submit transfer documents – see Terms and Conditions on the last page.
Passport Information
Print your name exactly as it appears in your passport
(Surname or family name)
Passport Number:
(First name(s))
Middle name(s)
Passport issued by:
Passport issue date:
(Month) /
(Day) /
(Year )
Passport expiry date:
(Month) /
(Day) /
(Year )
Signatures
By checking this box, I confirm that the information submitted via this application is correct and that I am registering for
this program. I understand that I am responsible for meeting all costs associated with the program. I have read the
attached CESL conditions).
____________________________ ___________________
Signature of applicant (required) Date
(required on paper application
________________________________ _____________________
Signature of parent or guardian
Date
(for applicants younger than 18 years)
SIU.EDU
CENTER FOR ENGLISH AS A SECOND LANGUAGE
FANER HALL – MAIL CODE 4518
1000 FANER DRIVE
CARBONDALE, ILLINOIS 62901
TELEPHONE: 618-453-2265 FAX: 618-453-6527
Will you spouse or children accompany you?
Yes /
No

You need to submit the DEPENDENT COPY I-20 REQUEST FORM (the form to be used is available for
download at http://cesl.siu.edu

A passport copy must also be submitted for each dependent listed.
SIU.EDU
CENTER FOR ENGLISH AS A SECOND LANGUAGE
FANER HALL – MAIL CODE 4518
1000 FANER DRIVE
CARBONDALE, ILLINOIS 62901
TELEPHONE: 618-453-2265 FAX: 618-453-6527
Student’s Name:
,
Email Address:
Agents (if applicable)
Are you being represented by a placement agency?
Yes /
No
If you answered “yes”, please enter the agent’s information below. All admissions correspondence will be sent to the agent by email.
Company name:
Name of agent/counselor:
Email address:
I-20 Mailing Instructions (if applicable)
CESL offers you the opportunity to receive your I-20 via DHL or FedEx through E-ShipGlobal
Receiving your immigration documents by courier is at your expense and your credit card will be charged upon
requesting the service. The DHL or FedEx Express mailing must be paid by credit card (VISA, MasterCard or
Discover cards only).
When your I-20 is ready CESL will send you directions to reach the website in order to register and activate
your account at
E-ShipGlobal. You may request a shipment either to your overseas address or to a U.S. contact address. If
your documents will be sent to a U.S. contact address, please include the name of the person at that address.
Study Dates
Please indicate which session(s) you plan to attend at CESL.


Select ALL sessions you wish to attend.
ALL students MUST attend the registration on the CHECK-IN date, followed by testing and orientation
days before their first session.
CHECK-IN Date
APPLICATION DEADLINE
06 October 2015
4 September 2015
05 January 2016
20 November 2015
15 March 2016
1 February 2016
07 June 2016
2 May 2016
16 August 2016
8 July 2016
11 October 2016
2 September 2016
* IF WE REACH FULL ENROLLMENT BEFORE THE DEADLINE, WE WILL NOTIFY YOU AND ADVISE YOU
TO CHANGE YOUR START DATE TO THE NEXT POSSIBLE ENTRY.
SIU.EDU
CENTER FOR ENGLISH AS A SECOND LANGUAGE
FANER HALL – MAIL CODE 4518
1000 FANER DRIVE
CARBONDALE, ILLINOIS 62901
TELEPHONE: 618-453-2265 FAX: 618-453-6527
Application Terms and Conditions
Refund Policy / Application fee: The application fee ($50) is not refundable.
Please note that a $1000 initial non-refundable tuition deposit may be required in order to complete your
admission. This one-time fee indicates your commitment to attend our Center and secures your course
enrollment. If you register as our student at the beginning of the term you have been admitted for, and
subsequently attend one term at CESL, that $1000 deposit will be credited toward your tuition. It will become
the final installment to complete your tuition payment. At the time of initial registration you will need to first pay
the normal student fees, the campus health insurance costs, and any other tuition less the amount of the
$1000 deposit you have made.
Paying by check or money order
If the application fee and tuition deposit are paid by check or money order, the application will not be
processed until the check or money order has been received in the mail.
Submit the application and all documents listed below by one of the following methods (you
must type your SURNAME in the subject line of the message):
1. By email to [email protected]
2. By Fax: 618-453-6527. Please include a cover sheet showing the student’s name and e-mail address.
3. Your friend may carry the documents to the CESL office:
1000 Faner Drive
Mail Code 4518
Faner Hall Room 3242 SIU in Carbondale
Carbondale, Illinois 62901, USA
Regular Students Application Checklist
The following documents must be submitted to CESL in order to complete an application:




A copy of the applicant’s passport
Financial Guarantee (the form to be used is available for download at http://cesl.siu.edu/)
Bank statement (see below)*
Certificate showing completion of secondary school if you are under 18 years of age
Transfer Students Application Checklist:









A copy of the first I-20 form, and the most recent I-20 form that the student has been issued
A copy of the student’s I-94
A copy of the F-1 student visa
Attendance form (the form to be used is available for download at http://cesl.siu.edu/)
Transcript from current language program
Financial statement (the form to be used is available for download at http://cesl.siu.edu/)
Bank Statement (see below)*
Current Financial Guarantee (only for students sponsored by the their government or embassy)
Transfer Verification form (the form to be used is available for download at http://cesl.siu.edu/)
SIU.EDU
CENTER FOR ENGLISH AS A SECOND LANGUAGE
FANER HALL – MAIL CODE 4518
1000 FANER DRIVE
CARBONDALE, ILLINOIS 62901
TELEPHONE: 618-453-2265 FAX: 618-453-6527
*Bank Statements
The applicant must submit his/her own bank statement or the bank statement of the person who will pay for the
applicant’s studies. It must show a balance of $4500 US for each intended session of study. The statement
must be written in English. The name of the account owner must be in English. The statement must clearly
show the type of currency held in the account.
US Permanent Residents or Citizens:
Submit copy of the permanent resident card (“green card”) or proof of US Citizenship (ex: a US passport)
Application Processing Time
Once all documents have been submitted, the application will usually be processed within 7-10 business days.
*Payment in full or proof of sponsorship is required at time of registration at the school or a $25 late fee may be assessed.
Students will not be permitted to enter classes until tuition or a financial guarantee is received.
SIU.EDU