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ELP FORM (AUAP)
First Name:
Last Name
Email Address:
Street Address:
City:
Postal (ZIP) Code:
Country
Tel:
Reason for Taking an ELP:
Length of the Stay
*
4 Weeks
6 Meeks
2 Months
One Semester
One Academic Year
Budget in US Dollars.( Includes University fees Lodging and meals):
*
Less than $4000
Less than $6000
Less than $8000
More than $8000
Preferred Location of the campus:
*
North East
Atlantic
South
Mid West
West (includes Texas)
California
Upper Pacific Coast
Alaska
Hawaii
Does not matter
Other important criteria:
Actual level of Studies
Will you be interested in pursuing further studies in America?
*
Yes
No
Do not know
Credt Card Number: (we accept Visa, Mastercard & American Express)
Expiration Date
Control Number (3 last digits on the back for Visa and Master Card, 4 printed digits on the front for American Express)
If different from the applicant, Name , First name, Billing address of the card holder:
I accept the charge of US $350 for the AUAP ELP program which will guarantee my acceptance in at least one English program in a US University.
*
Thanks, we will first process your card and then an AUAP personal counselor will contact you . AUAP Suite 19, 5053 Ocean Blvd Sarasota FL 34242 USA Tel:+!9413461427 Fax;+19413494370 Email;eval@auap.com
*
=
Input is required
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