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Application for Admission

- Step 1 of 3

Personal Information

Name *

First

Last

Email *

Confirm Email

Phone *

Date of Birth *//

Gender *

Male
Female

How did you hear about us. *

If Friend/Family or Other, please specify. *

If you are referred by an agency, please state the name of the company.

Do you have or need an F-1 visa? *

An F-1 visa is a non-immigrant visa for those wishing to study in the U.S.

What is your status? *

Initial (I want to go to the US. I need an F-1 visa.)
COS (I am in the US. I want to change my visa to F-1.)
Transfer (I have an F-1 visa. I want to transfer.)

Country of Birth *

City of Birth *

Country of Citizenship *

Where are you staying? *

In the US
Outside the US

U.S. Address (Your home address in the U.S.) *

Address Line 1

Address Line 2

City

State

Zip Code

Foreign Address (Your home address outside the US.) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Mailing Address (Complete if different from the above.)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you have dependents you want to add on your Form I-20? *

Only the spouse and unmarried minor children (under 21 years old) of an F-1 student are eligible to enter the United States in F2 dependent status.

If Yes, how many dependents? *

One
Two
Three
Four or more

Dependent 1

Relationship *

Spouse
Child

Gender *

Male
Female

Name *

First

Last

Date of Birth *//

Country of Birth *

City of Birth *

Country of Citizenship *

Dependent 2

Relationship *

Spouse
Child

Gender *

Male
Female

Name *

First

Last

Date of Birth *//

Country of Birth *

City of Birth *

Country of Citizenship *

Dependent 3

Relationship *

Spouse
Child

Gender *

Male
Female

Name *

First

Last

Date of Birth *//

Country of Birth *

City of Birth *

Country of Citizenship *

Additional Dependents

Please list additional dependents in the same format. *

Program

Which type of courses? *

Online Courses (Poly Live)
Offline Courses (Face-to-face)

Which School Location? *

POLY Languages Institute at Irvine
POLY Languages Institute at Los Angeles

Because of the COVID19 crisis, F-1 students may attend online classes. However, with a 30-day notice, F-1 students are required to attend offline classes (18+ hours per week) to maintain their status.

When would you like to start? *

How many weeks do you plan to study? *

Our terms are 4 weeks long.

Airport Transfer and Housing Services

Do you want us to arrange your airport pick-up? *

POLY Languages Institute provides airport pick-up service from the Los Angeles International Airport (LAX) to the school you will be attending or to the place of your choice within 10 miles of the school. The airport transfer service fee is $100, and it is due 20 days prior to the scheduled arrival date.

Do you want us to arrange your housing? *

POLY Languages Institute provides housing services. If you want your housing arranged in a timely manner, you should request the service at least 20 days prior to your desired move-in date. The housing arrangement service is $200.

If 'Yes', what type of housing do you prefer? *

Dormitory
Homestay
Doesn't matter

Please note that the type of housing is not guaranteed. The dormitories are available only for the school in Irvine, CA.

Do you have any health problems, allergies, or concerns you would like us to know?

The information you state the above will be disclosed, if deemed necessary, to the applicable parties related to your housing.

Tuition and Fess

For F-1 Initials and COS, only the application fee and the mailing fee (if applicable) are due with the Application for Admission.

Application Fee (F-1) *

$150 (non-refundable)

Application Fee *

Mailing and Handling Fee *

$80 (non-refundable)

Student Visa Assistance Service (F-1 Initial) *

$250 (non-refundable)

Do you need assistance in applying for your F-1 Visa? The Student Visa Assistance Service includes the following:
* We assist you in paying the SEVIS Fee.
* We assist you in completing the Visa Application (Form DS-160).
* We assist you in scheduling and preparing for your F-1 Visa Interview.
* We can send you another acceptance packet without charge if your visa is rejected.
* We provide credit of $250 towards your tuition. In other words, you pay $250 less in tuition.

Which Program? *

General Courses
Private/Group Lessons

For General Courses, students must be 17+ years of age. For Private/Group Lessons, students must be 12+ years of age.

Which Payment Plan? *

I would like a Special.
I will pay monthly (4 weeks).
I will pay later, 10 days before my scheduled start date.

For details, please visit Tution & Fees.

Courses (4 weeks) *

General English ($160)
Business English ($160)
Academic English L/S ($400)
Academic English R/W ($400)
TOEFL Prep L/S ($400)
TOEFL Prep R/W ($400)

Specials

Specials for Non F-1s *

Long Term Promo - Part-Time
Long Term Promo - Full-Time

* Long Term Promo for Part-Time applies to one course from Business English, General English, or IELTS Prep courses.
** Long Term Promo for Full-Time applies to two courses from Academic English or TOEFL Prep courses.

Specials for F-1 Transfers *

Long Term Promo - Full-Time
Covid19 Special - Full-Time

* Long Term Promo for Full-Time applies to two courses from Academic English or TOEFL Prep courses.
** Covid19 Special for Full-Time applies to two courses: one from Academic English or TOEFL Prep courses – and the other from General English, Business English, or IELTS courses. Furthermore, it applies only to the courses offered after 1:00 pm.

Long Term Promo - Part-Time *

It applies to one course from Business English, General English, or IELTS Prep courses.

Long Term Promo - Full-Time *

It applies to two courses from Academic English or TOEFL Prep course.

Covid19 Special - Full-Time *

It applies to two courses: one from Academic English or TOEFL Prep courses – and the other from General English, Business English, or IELTS courses. Furthermore, it applies only to the courses offered after 1:00 pm.

Private/Group Lessons

How many lessons? *

Each lesson is 80 minutes long.

How many students? *

There is a charge of $60 per student per term (4 weeks).

Total Due *

$ 0.00

Once you're accepted, we will assist you with all aspects of the admission process.

Stripe Credit Card *

Card

Name on Card

Acknowledgement and Agreement

I acknowledge that I have access to the School Catalog, and I have read, understood, and I agree to all the terms and conditions of this Application for Admission and the School Catalog. Furthermore, I agree to accept full responsibility for all my expenses while attending POLY Languages Institute and for my actions while participating in excursions or any other activities. I agree to assume all risks of harm arising from such participation. In case of illness or injury, permission is granted to an appropriate medical center to undergo examination or treatment. I further authorize POLY Languages Institute to release my records to my agency, guardian, sponsor, and to any colleges or universities to which I apply.

Agreement *

I understand and agree to the terms and conditions stated herein.

Website

Apply Now

Application for Admission

Personal Information

Program

Airport Transfer and Housing Services

Tuition and Fess

Specials

Private/Group Lessons

Acknowledgement and Agreement