Enrollment Application Form

To submit your Enrollment Application request, simply fill out the form below and press submit
or click here to download and fill out a PDF version of this form.

Personal Information Family Name*
Given Name*
Date of Birth (Month/Day/Year)*
Gender Male Female
Nationality
Native Language
Current Occupation
Agency Name (if applicable)

Home Contact Information Country*
Address 1*
Address 2
City
State/Prov
Postal Code
Phone
Fax
Mobile
Email*

Visa Information Passport Number
Passport Expiry (Month/Day/Year)
Type of Visa Student(F-1) B1/B2tourist Visa Waiver Other

Educational Background Highest Level of Education.
Have you completed an Eng. Course Yes No
When? (Month/Day/Year)
Where?
Course Duration? (# of months)
TOEFL score
TOEIC score
Level Completed? Beginner Intermediate Advanced
Your current level of Eng. is? Beginner Intermediate Advanced

Misc Do you require airport pickup? Yes No
Do you want Homestay? Yes No
Comments

Refund Policy Refund Policy

     GEOS LA-SOUTH BAY CANCELLATION AND REFUND POLICY FOR FULL-TIME COURSES
     ---------------------------------------------------------------------      

CANCELLATION POLICY: (prior to or on the first day of class)
 If an applicant accepted by GEOS cancels for any reason prior to or on the first day of class, 
  he/she will receive a full refund of all monies, less the application and homestay placement fee (if applicable)

WITHDRAWAL POLICY: (after start of class)
 The term of enrollment varies for each student based on the number of weeks specified on his or her enrollment
  documents. Refund calculations for students who withdraw after the beginning of their classes is based on the
  term of enrollment.

  -If notice of withdrawal is received by GEOS, or a student is dismissed within the first 4 weeks of the program
    of study's duration, GEOS will retain 4 weeks of tuition and will refund the dollar amount equal to the
    remaining number of weeks of the period of study.
  -If notice of withdrawal is received by GEOS after 4 weeks of the term of study and before the midpoint of the
    term, GEOS will prorate the tuition in terms of weeks and will refund the dollar amount equal to the remaining
    number of weeks of the period of study.
  -If a student withdraws after the midpoint of the term of study, no refund will be given.
  -If an already enrolled student who signs up for additional terms of study withdraws before the midpoint of their
    new term, he/she will receive a prorated refund by week up to the midpoint of the term. There will be no refund
    after the midpoint.

*GEOS is not obligated to make any refunds to students who are terminated due to the violation of its written
 disciplinary and/or attendance policies, or local, state or federal law.

*No refunds are made after the student has completed more than 50% of the program of instruction

REFUND DUE DATES:
  -All refunds will be paid within 45 calendar days of the first day of the term for those students that cancel.
  -All refunds will be paid within 45 calendar days of written notification for those students that withdraw.
  -Students who enroll at GEOS with an overseas agency should collect their refund from that agency directly

I have read and agree to the GEOS Los Angeles Refund Policy*

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Enrollment Application Form