Apply to POLY Languages Institute

Application for Admission

Please fill out the form below to get started. We’ll be in touch with the next steps soon.

– 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, Agency, or Other, please specify. *

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

An F-1 visa is required for full-time international students studying in the U.S.

What is your status? *

Initial – I need an F-1 visa to enter the U.S.
Change of Status – I am in the U.S. and want to change to F-1.
Transfer – I already have F-1 status and 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

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

Dependents are spouses and/or unmarried minor children. Children 21 years of age or older are not eligible to enter as the dependent of an F-1 student.

Dependent Information

Relationship *

Spouse
Child

Gender *

Male
Female

Full Name *

First

Last

Please enter your given name (first name) and family name (last name) as they appear on your passport.

Date of Birth *

Country of Birth *

City of Birth *

Country of Citizenship *

Program

Which program would you like to enroll in? *

General Courses
Private Lessons (Online)

Note: General Courses are for students age 17 and older. Private/Group Lessons (Online) are available for students age 10 and older.

How would you like to attend your classes? *

Online
In-Person (Face-to-Face)

Which school? *

POLY Languages at Irvine
POLY Languages at Los Angeles

If you’re attending online, your student records will be maintained at the school you select.

When would you like to start? *

How many weeks do you plan to study? *

Note: Each term is 4 weeks long.

How many hours per week? *

Housing Service

Do you need housing? *

POLY offers a Homestay Program for international students arriving from overseas. A non-refundable service fee of $200 applies. For full housing terms, please refer to the School Catalog or contact us.

Do you have any health concerns, allergies, or other information we should be aware of?

Your response may be shared with housing coordinators or host families, if necessary.

Private Lessons

Which days are you available for lessons? *

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Select all the days you’re available for lessons. The more flexible your schedule, the better we can match you with a tutor.

What time of day is best for you to start your lessons? *

Enter your preferred start time — any time between 7:00 AM and 10:00 PM Pacific Time (PT).

Additional Notes or Comments

(Optional) Use this space to share any preferences, questions, or special circumstances.

Application and Service Fees

Application Fee for F‑1 Student (non‑refundable)

Price: $150.00

Application Fee for Non-F‑1 Student (non‑refundable)

Price: $75.00

F-1 Initial Processing & Visa Support Fee (non-refundable)

Price: $250.00

Includes SEVIS I-901 and DS-160 assistance, F-1 visa interview preparation, and issuance of your Form I-20 by email. Physical shipment is available upon request and will incur additional courier fees.

Housing Arrangement Service (non-refundable)

Price: $200.00

Which lesson package would you like to purchase? *

Each lesson is 50 minutes long. Select the package that fits your schedule.

How many students will attend the lessons? *

Group lessons are based on the private lesson package plus $60 per additional student per term (4 weeks). The total is shared among all group members.

Total Due *

$0.00

Once we receive your application, we will review it and contact you.

Assisted by (Optional)

Stated the name of the advisor who assisted you in completing this form.

Stripe Credit Card *

Card

Name on Card

Acknowledgement and Agreement *

By checking the box and submitting this Application for Admission, I confirm that I have reviewed the digital School Catalog of Poly Languages Institute and agree to its terms and conditions. If I am applying as an F-1 student, I understand that I am required to complete a minimum of 18 hours of instruction per week in accordance with federal regulations. I acknowledge that online instruction may only count toward the required hours if I physically attend those classes at the school under staff supervision. I accept full responsibility for all expenses I incur during my enrollment, including but not limited to tuition, housing, and other personal or academic costs. I also acknowledge that my participation in any excursions or school-sponsored activities is voluntary and at my own risk. Accordingly, I release POLY Languages Institute from any liability for injury or harm I may experience during such activities.

Change of Status (COS) Acknowledgment & Agreement *

I understand and agree that (1) if I am approved to proceed with a Change of Status (COS), I must pay the COS service fees: $650 COS service fee, $300 deferral fee, and $100 per dependent (if any), (2) I must prepay at least 7 terms (28 weeks) of tuition as listed in the Catalog, (3) I must remain enrolled for at least 7 terms (28 weeks) to fulfill my commitment period, (4) if I withdraw before completing the commitment period, my SEVIS record will be terminated and I will be out of F‑1 status, and (5) any tuition refund will follow the school’s official refund policy in the Catalog.

Private/Group Lessons *

I acknowledge that all Private/Group Lessons at POLY Languages Institute are conducted fully online. I understand that tuition is non-refundable and that lesson scheduling depends on teacher availability. Learning materials may be recommended by my tutor, and any purchases are optional and made at my discretion.

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