Enrollment Application Form

To submit your Enrollment Application request, simply fill out the form below and press submit
or click here to download and fill out a PDF version of this form.

Personal Information Family Name*
Given Name*
Date of Birth (Month/Day/Year)*
Gender Male Female
Nationality
Native Language
Current Occupation
Agency Name (if applicable)

Home Contact Information Country*
Address 1*
Address 2
City
State/Prov
Postal Code
Phone
Fax
Mobile
Email*

Visa Information Passport Number
Passport Expiry (Month/Day/Year)
Type of Visa Student(F-1) B1/B2tourist Visa Waiver Other

Educational Background Highest Level of Education.
Have you completed an Eng. Course Yes No
When? (Month/Day/Year)
Where?
Course Duration? (# of months)
TOEFL score
TOEIC score
Level Completed? Beginner Intermediate Advanced
Your current level of Eng. is? Beginner Intermediate Advanced

Misc Do you require airport pickup? Yes No
Do you want Homestay? Yes No
Comments

Refund Policy Refund Policy

          GEOS LA-COSTA MESA CANCELLATION AND REFUND POLICY FOR FULL-TIME COURSES
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CANCELLATION POLICY (prior to or before starting class on the 1st day):
If an applicant accepted by GEOS cancels for any reason prior to or before starting class on the 1st day, 
he/she will receive a full refund of all monies, less the Application Fee and Document Shipping Fee (as shown
as not refundable on the enrollment agreement), and all other fees for services rendered.  
       
WITHDRAWAL POLICY (after start of class):
The term of enrollment varies for each student based on the number of weeks specified on his or her enrollment 
documents. Refund calculations for students who withdraw after the beginning of their classes is based on the 
term of enrollment.
     
  -If notice of withdrawal is received by GEOS, or a student is dismissed within the first 4 weeks of the program 
  of study's duration, GEOS will retain 4 weeks of tuition and will refund the remaining amount of paid tuition.
  -If notice of withdrawal is received by GEOS after 4 weeks of the term of study and before the midpoint of 
  the term, GEOS will retain the full price for the number of weeks completed and will refund the remaining 
  amount of paid tuition.  
  -If a student withdraws after the midpoint of the term of study, no refund will be given.
  -If an already enrolled student who enrolls up for additional terms of study withdraws before the midpoint of 
  their new term, GEOS will retain the full price for the number of weeks completed and will refund the remaining 
  amount of paid tuition up to the midpoint of the new term.  There will be no refund after the midpoint of the 
  new term. 
  -GEOS is not obligated to make any refunds to students who are terminated due to the violation of its written 
  disciplinary and/or attendance policies or local, state, or federal law.
         
REFUND DUE DATES:
  -All refunds will be paid within 45 calendar days of the first day of the term for those students that cancel.
  -All refunds will be paid within 45 calendar days of written notification for those students that withdraw.
  -Students who enroll at GEOS with an overseas agency should collect their refund from that agency directly.
     
Note: All tuition discounts or special offers are dependent upon completion of the toal contracted weeks of study.
If a student withdraws or shortens their course after the first day of class, but before completing 50% of their 
contracted number of weeks, the student will be charged full price for the number of weeks completed when 
calculating a refund. 
     
Students who are dropped administratively due to violations of school policies are not eligible for refunds.  
     
          GEOS LA-COSTA MESA CANCELLATION AND REFUND POLICY FOR PART-TIME COURSES
          --------------------------------------------------------------------
     
CANCELLATIONS:
If a program is cancelled by the institution all monies will be refunded to students. 
      
If a student does not appear at the school for their classes, and later asks for a refund, the institution will 
refund all monies paid by the student, less the application fee (as shown as not refundable on the enrollment 
agreement), and all other fees for services rendered.
      
If a student cancels a contract prior to the class start date, all refunds due will be made within 45 days of the 
first scheduled day of class or the day of cancellation, whichever is sooner. 
      
For enrolled students, the refund due will be calculated through the last day of attendance and will be paid 
within 45 days from the documented date the student drops from the program. 
      
REFUND CALCULATION:
If notice of withdrawal is received by GEOS on the first day of class and through the midpoint of the contracted 
term of study, GEOS will retain the full price for the number of hours completed and will refund the remaining 
amount of paid tuition.  After the student has completed 50% of the contracted term of study no refund is due the 
student.  Charges for extra costs such as books, supplies or equipment, and application fees are not subject to 
these refund computations.  For students who cancel prior to the class start date, refunds will be made within 45 
days of the first scheduled day of class or the date of cancellation, whichever is sooner.  Refunds for enrolled 
students will be paid within 45 days of the documented  drop date.  
      
Note: No refunds are made after the student has completed more than 50% of the program of instruction. 

Students who are dropped administratively due to violations of school policies are not eligible for refunds.
      
Classes must be cancelled the day before the scheduled lesson.  Same day cancellations will be forfeited.  All 
cancellations and schedule changes must be made through the school office - no exceptions.  For semi-private 
tutoring classes, absences can not be made up or rescheduled.  
       
TRANSFER:
F1 students in good academic standing, and in F1 status (not "Out of Status"), are eligible for academic 
transfer if they have completed a minimum of 12 weeks of class, or 100% of their contract (whichever comes first).

I have read and agree to the GEOS USA Refund Policy*

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have been studying English at GEOS for three months. The teachers and staff here are enthusiastic. They are always pleased to help student's with their problems. It is interesting to meet friends from different countries. Through conversation with them, I've improved my listening and speaking a lot. It's been a good learning experience.

Chang Hui Min
Taiwan

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Enrollment Application Form

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