English Language Institute
Student Application

Please check the session which you wish to attend.

4-Week Session*

July 13-August 11, 2019

Language & STEM Language & Culture

Would you like to attend the Experiential Travel Session?*

August 11-August 18, 2019 | 7-day travel session: $3,200

Yes No

Student's family namerequired

First namerequired

Middle name

Preferred name/English name

Gender*

Male Female

Birthdaterequired

Use this format: MM/DD/YY

Do you wish to apply for financial aid?*

Yes No

Student's Country of Citizenshiprequired

Country of Birthrequired

Student's name EXACTLY as it appears on passportrequired

Does student currently have an F-1 Visa?*

Yes No

What is the Name of the Institution the issued your I-20?

If you are currently in the United States, will you travel outside the U.S. before attending Summer at Sem?

Yes No

Will you travel to your home country immediately following Summer at Sem?*

Yes No

Will you attend a boarding school in the U.S. after Summer at Sem?*

Yes No

Please provide name of school:

Number of years studying English?required

Estimated level of English proficiencyrequired

Student's phone:

Country code

Home phone numberrequired

with area/city code

Student's mobile phone

with area/city code

Student's e-mailrequired

Parent's e-mailrequired

Student's address:

Street addressrequired

Address 2

Address 3

Cityrequired

Staterequired

Zip/postal coderequired

Countryrequired

Have you ever attended Summer at Sem?*

Yes No

If yes, indicate whenrequired

Did the Summer at Sem Office provide you with an office code?*

No Yes

Office coderequired

How did you hear about Summer at Sem?

Do you have any relatives or friends who attended Wyoming Seminary?

Name of current schoolrequired

Name of school official who speaks Englishrequired

Official's email addressrequired

Number of years attendedrequired

Street address of current schoolrequired

Cityrequired

Staterequired

Zip or country coderequired

Countryrequired

Country code

Phone number of schoolrequired

with area/city code

Fax number of school

with area/city code

Grade completed before the start of summer schoolrequired

Student currently attends:required

Family Information

Student's Lives With:*

Both Parents Mother only Father only Guardian Other

Legal Custody*

Both Parents Father Mother Guardian Other

Financial Responsibilty:*

Both parents Father Mother Guardian Other

Student's Parents:*

Together Divorced Separated Father deceased Mother deceased Other

Please specifyrequired

PARENT/GUARDIAN #1 INFORMATION

Please indicate the relationship of parent or guardian #1 to the student:required

Prefix

First namerequired

Middle

Last namerequired

Suffix

Address line 1required

Address line 2

Cityrequired

State

Region

Zip

Countryrequired

Citizenship

Occupation

Employer

Daytime phone number

Include area/city code

Country code

If applicable

Parent mobile phonerequired

with area/city code

Parent evening phone

with area/city code

Parent email addressrequired

Would you like to enter information for Parent/Guardian #2?*

Yes No

PARENT/GUARDIAN #2 INFORMATION

Please indicate the relationship of parent or guardian #2 to the student:

Prefix

First name

Middle

Last name

Suffix

Address line 1

Address line 2

City

State

Region

Zip

Country

Citizenship

Occupation

Employer

Daytime phone number

Include area/city code

Country code

If applicable

Parent mobile phone

with area/city code

Parent evening phone

with area/city code

Parent email address

Name for admission materials (if different from student)

Email for admission materials (if different than parent's email)

CONTACT INFORMATION

Name of contact who speaks Englishrequired

Relationship to studentrequired

Email Addressrequired

Phone numberrequired

Please note to complete the application process, all applicants must also submit:

• 1 Teacher recommendation.

• A transcript request form and an official copy of your transcripts with an English translation.

Please mail these supplementary forms to Wyoming Seminary, Summer at Sem, 201 N. Sprague Avenue, Kingston, PA 18704 U.S.A or email to summeratsem@wyomingseminary.org.

If financial aid was requested a separate application will be email to you.

An application fee in the amount of $125 is due with this submission and payable by credit card. We accept the following credit cards: Visa, Mastercard and American Express.

Wyoming Seminary requires all boarding and day students to be in compliance with Pennsylvania State Immunization requirements. We do not accept exemptions. Questions regarding immunization requirements should be directed to Beth Blaum R.N., B.S.N. Director of Student Health Services, at (570) 270-2180.

Wyoming Seminary maintains an open admission policy. Any student, regardless of race, color, religion, national or ethnic origin, may apply for admission to the school. This policy embodies Wyoming Seminary's commitment to enriching students' experience by living in a multicultural community.

Click the "submit" button to proceed.

English Language Institute Student Application

Family Information

English Language Institute
Student Application