Name : Address :        City : State : Postal Code :  Country :         Tel. : Fax :    E-mail : When do you want to come to the US?      Month : January February March April May June July August September October November December      Year : Which state or region, e.g. Massachusetts, Midwest?      Ans -    What is your English level? Advanced Intermediate Beginning Other Have you taken the TOEFL? Yes No if Yes, when? Type:  IBT CBT Pencil and Paper Score (if you remember): Do you want us to assist with accommodations? Yes No If Yes, please specify: Dormitory Homestay Apartment Are you interested in distance learning? Yes No   Are you studying now? Yes No If yes, where? Are you working? Yes No If yes, where? What else should we know about you? Please use the lines below for comments, questions, etc.      Ans -