APPLICATION FORM Please check ( ✔ ) for which semester/session you wish to apply DEADLINE FALL 2009 (SEPT. 6 – DEC. 3, 2009) ☐ AUG. 15, 2009 WINTER/SPRING 2010 (JAN.4 – APRIL 2, 2010) ☐ NOV. 15, 2010 SUMMER 2010 (JUNE 21 – AUG. 20, 2010) ☐ MAY 15, 2010 FALL 2010 (SEPT. 5 – DEC. 3, 2010) ☐ AUG. 1, 2010 LET US KNOW ABOUT YOU LAST NAME: _______________________________ FIRST NAME: _______________________________ GENDER: F☐ M ☐ DATE OF BIRTH: __/ __/ __ MO DAY YR NATIONALITY: _______________________________ CURRENT MAILING ADDRESS: _________________________ _________________________ _________________________ EMAIL ADDRESS: _________________________________________ UNIVERSITY/BUSINESS SCHOOL PRESENTLY ATTENDED: _________________________________________________________ MAJOR OF STUDY: ______________________________ MINOR OF STUDY:(IF ANY) ______________________________ HOW WOULD YOU RATE YOUR ENGLISH PROFICIENCY? •SPOKEN: GOOD ☐ FAIR ☐ AVERAGE ☐ POOR ☐ • WRITTEN: GOOD ☐ FAIR ☐ AVERAGE ☐ POOR ☐ SIGNATURE: ___________________ DATE: __________ PLEASE, SCAN AND EMAIL THE COMPLETED AND SIGNED APPLICATION FORM TO: apply@ asiacademy.com, c/o Dr. Francis Piron Tuition Payments and Refund Policy AsiAcademy’s tuition fee is invoiced in three components, as indicated on the website (“Tuition Fees”). AsiAcademy reserves the rights to alter fees, as necessary. Upon registration (i.e., once the completed application form and 25% payment are received) participants receive an admission letter and receipt. While the registration fee is not refundable, it is transferable to another semester/session. The balance of the program fees is due as indicated on the website and confirmed in the acceptance letter. In the event of cancelation between 1 week and 29 days of the beginning of the semester AsiAcademy will refund 40 % of the program fee. There will be no refunds after the beginning date of the program. Force Majeure Force majeure means any circumstances beyond the reasonable control of AsiAcademy including, but not limited to, acts of God, explosion, flood, tempest, fire or accident, earthquake, war or threat of war, sabotage, terrorism, insurrection, civil disturbance, requisition, sickness, quarantine, government intervention, adverse weather conditions or other untoward occurrences. Should AsiAcademy’s program be impacted by force majeure, it will immediately notify the participants.
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