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1 PageOAKLAND UNIVERSITY ESL INSTITUTE APPLICATIONCONTINUING EDUCATION UNITS (CEUS) NON- CREDIT ESL COURS ESDATE OF APPLICATION / /LEGAL NAME (As shown on passport):LAST NAME (family name/surname)FIRST NAMEMIDDLE NAMEGENDERMALE FEMALE NUMBER, STREET, APT. Current International Mailing Address (No PO Boxes) You must include street and house number.CITYSTATE/PROVINCECOUNTRY OF BIRTHCOUNTRY OF CITIZENSHIPEMAIL ADDRESS (please print):International Phone:COUNTRYZIP/POSTAL CODENATIVE LANGUAGEDate of Birth (month/ day/ year)/INTERNATIONAL STUDENTU.S.PERMANENT RESIDENTU.S. CITIZENHAVE YOU PREVIOUSLY APPLIED FOR ADMISSION TO OAKLAND UNIVERSITY?HAVE YOU ATTENDED OAKLAND UNIVERSITY?/YES NO YES NO YES NO YES NO YES NO IF YES, WHEN?(YEAR)REGISTRATION INFORMATION – Non-credit (CEU)Please select the semester you are registering for by placing a check in the appropriate semester box below.Your course level placements will be decided upon completion of the online assessment. Four language proficiency levels are offered:foundations, beginning, intermediate and advanced. 4 Courses are Required (F-1 Visa Holders only)Required Courses OfferedElective Courses Offered Listening and Speaking(must choose one) Reading and Vocabulary Academic Writing and SentenceCommunicationsStructure Grammar Test Preparation Fall (September-December) - 16 weeks4 Courses are Required (F-1 Visa Holders only)Required Courses OfferedElective Courses Offered Listening and Speaking(must choose one) Reading and Vocabulary Academic Writing and SentenceCommunicationsStructure Grammar Test Preparation Computer Literacy Summer 01 (May-June) - 8 weeks3 Courses are Required (F-1 Visa Holders only)Required Courses OfferedListening and SpeakingReading and VocabularyWriting and Sentence StructureWinter (January – April) - 16weeks Summer 02 (June-August) - 8 weeks3 Courses are Required (F-1 Visa Holders only)Required Courses OfferedListening and SpeakingReading and VocabularyWriting and Sentence StructurePlease check off how many semesters you plan to attend? 1 2 3 4 OR one yearREAD BEFORE SIGNING: I UNDERSTAND THAT WITHHOLDING INFORMATION REQUESTED, FALSIFICATION OFINFORMATION, OR MISREPRESENTATION OF ANY PORTION OF THIS APPLICATION MAY BE CAUSE FORCANCELLATION OF ADMISSION, FINANCIAL AWARD OR APPOINTMENT.SIGNATURE OF APPLICANTDATE
2 PageOAKLAND UNIVERSITY ESL INSTITUTE APPLICATIONCONTINUING EDUCATION STATUS (CONTINUED)WILL YOU NEED AN F-1 VISA TO ATTEND OAKLAND UNIVERSITY’S ESL INSTITUTE?YES NO FOR INTERNATIONAL STUDENTS ONLYARE YOU CURRENTLY IN THE UNITED STATES?YES NO WHAT TYPE OF VISA DO YOU CURRENTLY HOLD (F-1, J-1, H-1, etc.)?ARE YOU TRANSFERRING FROM ANOTHER UNIVERSITY IN THE U.S.?YES NO IF YES, GIVE THE NAME AND CITY OF THAT SCHOOL:If yes, you must submit a copy of your current SEVIS I-20 form, passport, visa, and I-94 card. Transfer students mustsubmit a Transfer-In Form, (as well as the application and all required documents) which can be obtained from:Oakland University ESL InstituteO’Dowd Hall Room 326586 Pioneer DriveRochester, MI 48309-4482USATelephone: 248.364.8803Fax: 248.370.3587Email: esl@oakland.eduWHERE SHOULD WE MAIL YOUR SEVIS I-20 FORM?LAST NAME (surname, family name)FIRST NAMECURRENT ADDRESSOTHER USA ADDRESS LISTED BELOWRELATIONSHIPNUMBER, STREET, APT. No PO Boxes. You must include street and house number.CITYSTATE/PROVINCEPHONE (COUNTRY, AREA & CITYCODE, LOCAL NUMBER)ZIP/POSTAL CODEUSA PHONE NUMBER(SIGNATURE (Only the student is to sign here.)COUNTRY)-DATEApplicants who need visa immigration documents or who are transferring their current visa must complete the “VisaApplication/Statement of Finances’ form (pages 3 and 4).Completed and signed application with required documents can be: Mailed to:Oakland University ESL InstituteO’Dowd Hall Room 326586 Pioneer DriveRochester, MI 48309-4482USATelephone: 248.364.8803Fax: 248.370.3587Email: esl@oakland.edu
3 PageESL INSTITUTEAPPLICATION FOR STUDENT VISASTATEMENT OF FINANCESIn addition to completing the ESL Institute Application Form (pages 1 and 2), all students requiring an F-1 visa or who are transferringtheir current visa must complete the information below.LEGAL NAME (As shown on passport):LAST NAME (family name/surname)FIRST NAMEMIDDLE NAMECOUNTRY OF BIRTHCOUNTRY OF CITIZENSHIPNATIVE LANGUAGEBefore Oakland University can offer admission to an international applicant to the ESL Institute and issue a Certificate of Eligibility(SEVIS I-20) for a student visa to the United states, the applicant must certify his/her ability to pay for the following:1. All regular school and living expenses associated with his/her stay in the United States;2. All expenses incurred because of illness or emergency treatment while in the United States;3. Immediate expenses upon arrival to Oakland University.Program Costs for the Summer S01 or Summer S02 (8 weeks each) session:TuitionHousing *Books and SuppliesMedical Insurance * *Total Cost 2,250.00 3,027.00 180.00 310.00 5,767.00Program Costs for the full semester in the Fall or Winter (16 weeks each) session:TuitionHousing *Books and SuppliesMedical Insurance**Total Cost 3,000.00 4,848.00 180.00 620.00 8,648.00*HOUSING IS NOT AVAILABLE AT THIS TIME for those students admitted into the ESL Institute Program.** These rates are estimates of Oakland University United Healthcare Student Insurance based on the 2016-2017 Academic CalendarYear and are subject to change. Please, go to oakland.edu/isso/health-insurance/ for additional health insurance information.IMPORTANT: Financial documentation for dependents must be included for admission purposes and I-20 issuance. Additional cost for 1st dependent is 2,165.00 for the fall or winter (16 week sessions). Additional cost for 1st dependent is 1,082.00 for the summer S01 or summer S02 (8 week sessions). Additional cost for 2nd dependent is 1,633.00 for the fall or winter (16 week sessions). Additional cost for 2nd dependent is 816.00 for the summer S01 or summer S02 (8 week sessions).Health Insurance: The cost of medical care in the United States is very high, and should hospitalization become necessary, the associatedexpenses may total hundreds of dollars per day. The only effective protection is to purchase a medical insurance policy upon arrival in theUnited States. Students are required to purchase and maintain health insurance that meets Oakland University requirements for the entireduration of their study in the United States. Rates listed for medical insurance are for students up to age 30. For rates for students 30 yearsold or older and for spouse/children, please contact the International Students and Scholars Office (ISSO).Do you have sufficient funds to cover the total expenses listed above?YES NO
4 PageESL INSTITUTEAPPLICATION FOR STUDENT VISASTATEMENT OF FINANCES (CONTINUED)Indicate below the sources and amounts of money, in U.S. dollars, that you will have available to you after you arrive atOakland University. (You must enclose a notarized financial statement signed by a bank official showing that you havesufficient funds available in U.S. dollars to cover the costs of the ESL Institute.)SourceAmounta) Personal savings b) Parental support* c) Scholarship from your company d) Support from other sponsor* e) Other support* Total Funds Available *If you have listed any support from a parent, sponsor, or other support (items (b), (d) or (e) above), you must furnish an original letter ofaffidavit from the source of support certifying that the funds will be available to you, as well as a letter from the source’s financialinstitution verifying that the amount of funds is available.IMPORTANTAll applicants must include a copy of the passport page on which their photo,passport number, and personal details appear.Will you have dependents with you while studying in the ESL Institute at OaklandUniversity? If so, a copy of your dependents’ passport is required.YES NO I certify that I have read and understood all of the regulations and information described in thisdocument and that I have answered all questions completely and truthfully. I agree to provideevidence of previously purchased health insurance coverage that will be effective in the U.S., or Iagree to purchase such coverage upon enrollment at Oakland University.(Only the student is to sign this form.)Signature Date
5 PageREQUIRED DOCUMENTATION CHECKLISTFOR F-1 APPLICANTS ONLY: ESL Institute Signed Application (pages 1 and 2) ESL Institute Signed Visa Application (pages 3 and 4) Notarized Financial Statement (calculated in U.S. Dollars) Copy of required passport page Copy of Health Insurance Policy (in English) for F-1 students if applicable Letter of Affidavit (in English) from Parent, Sponsor, or Other Support if applicable Copy of dependent’s passport page if applicable Transfer-in-form if applicableINTERNATIONAL STUDENTS AND SCHOLARS OFFICEThe International Students and Scholars Office (ISSO) provides support for international students taking classes atOakland University and international scholars on campus. The International Students and Scholars Office iscommitted to building an international campus through service, support and advocacy to nurture global citizenshipand multicultural appreciation. The office provides services to international students and scholars, includingimmigration-related advising, social and cultural counseling, and helpful orientation sessions to new students andscholars. The ISSO also advocates on behalf of international students and scholars at the university and in theneighboring community.OFFICE OF DISABILITY SUPPORT SERVICESThe Office of Disability and Support Services provides support services for students who need special help for asuccessful experience at Oakland. The office assists students who have disabilities or physical handicaps andshould be consulted about available services either before or at the time an application is made. Address requestsfor information to the Office of Disability and Support Services 248.370.3266.EQUALITY OF OPPORTUNITYOakland University, as an equal opportunity and affirmative action institution, is committed to compliance withfederal and state laws prohibiting discrimination, including Title VI of the Civil Rights Act of 1964, Title IX of theEducation Amendments of 1972 and Section 504 of the Rehabilitation Act of 1973. It is the policy of OaklandUniversity that there shall be no discrimination on the basis of race, sex, color, religion, national origin or ancestry,age, marital status, handicap, veteran status or other prohibited factors in employment, admissions or otheractivities.Completed and signed application with required documents can be:Mailed to:Oakland University ESL InstituteO’Dowd Hall Room 326586 Pioneer DriveRochester, MI 48309-4482USATelephone: 248.364.8803Fax: 248.370.3587
OAKLAND UNIVERSITY ESL INSTITUTE APPLICATION CONTINUING EDUCATION UNITS (CEUS) NON-CREDIT ESL COURSES . Transfer students must submit a Transfer-In Form, (as well as the application and all required documents) which can be obtained from: Oakland University ESL Institute Telephone: 248.364.8803 O'Dowd Hall Room 326 Fax: 248.370.3587 .
