Intensive English Online

Intensive English ONLINE

Pittsburg State University

Application Form

Name*

First Name

Last Name

Email*

Confirm Email *

Gender*

Male Female

Date of Birth*

Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Country of Citizenship*

Country of Residency*

Phone

Education Background

Select the highest degree you have earned*

High School Diploma Bachelor’s Degree Master’s Degree PhD

Have you studied English in the past?*

Yes No

If yes, when and where?

English Test Scores

If you have taken one of the following standardized English tests, please indicate your score:

Duolingo TOEFL IELTS PTE

(The Duolingo English Test is required for proper level placement)

What's the score?*

What's the score? *

What's the score?*

What's the score? *

Which courses are you interested in?

ELEMENTARY LEVEL

IEP-025 Elementary Structure & Composition (Grammar & Writing) IEP-026 Elementary Reading, Listening & Speaking

INTERMEDIATE LEVEL

IEP-045 Intermediate Structure & Composition (Grammar & Writing) IEP-046 Intermediate Reading, Listening & Speaking

ADVANCED LEVEL

IEP-065 Advanced Structure & Composition (Grammar & Writing) IEP-066 Advanced Reading, Listening & Speaking

Please select the session you plan to start:*

Spring Session 1 (January-March) – 8 weeks Spring Session 2 (March-May) – 8 weeks Summer Session 1 (May-June) – 5 weeks Summer Session 2 (July-August) – 5 weeks Fall Session 1 (August-October) – 8 weeks Fall Session 2 (October-December) – 8 weeks

Do you have a reliable computer with internet access*

Yes No

Does your computer have a webcam, microphone, and speakers?*

Yes No

Are you able to meet online for the required lesson times?*

Yes No

Do you plan to study in the USA in the future?*

Yes No

How did you hear about this program?

Social Media (Facebook/Instagram) Agent EducationUSA Advisor/Counselor Friend/Family Internet search (Google)

Other:

What questions or comments do you have?

*

Yes, I understand that I must pay the tuition before I can begin this course. Yes, I understand that I must submit a Duolingo English Test in order to be placed in the proper course level.