Online Application

Name*
First Last
Gender*
- Male
- Female
Date of Birth*
Applicant must be at least 16 years of age or older
Email*
Did you see our promotion on any of the following websites?
- Google
- Facebook
- Instagram
- None

Personal Information — for Student Visa (F1) Applicants
Country of Citizenship*
Country of Birth*
City of Birth*
Do you already have a valid F-1 Visa?
- Yes
- No, I will apply
- No, I will change my status
- Other
Do you have dependents who will apply for an F-2 Visa?*
- Yes
- No
Foreign Address
Address in your home country
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Contact Number in your home country

Address in Hawaii
(If known)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Local (U.S.) Phone Number

Academia's Refund Policy
Please Read and Acknowledge*
- I understand that Academia has the right to change policies, prices and programs without prior notice.
- I certify that the information provided on the application form is correct.
- I will be responsible for reading, understanding, and accepting all school policies. I further agree to all terms and conditions provided by Academia Language School.
- I have read, understand and agree to Academia's refund policies.
- Textbook fee is not included. Textbook fee is roughly $85-$100 per term.
- If a student is under 18 years old, then a legal guardian must sign on behalf of the student.
By checking the boxes above, you are acknowledging you understand Academia's policies.
Name*
First Last
Please sign above to acknowledge you understand Academia's policies listed above.
File
Drop files here or
Please feel free to upload your enrollment documents (ex: bank statement, copy of bank statement, etc.) here.
Comments
This field is for validation purposes and should be left unchanged.

Personal Information — for Student Visa (F1) Applicants