HOSPITALITY INTAKE FORM

1. YOUR FAMILY NAME

2. YOUR FIRST NAME

3. YOUR AMERICAN OR NICKNAME (IF YOU HAVE ONE)

4. FULL NAME OF PERSON WHO RECOMMENDED TESSUSA; or, HOW YOU FOUND US

5. YOUR DATE OF BIRTH

6. STREET ADDRESS

7. BUILDING NUMBER , APARTMENT NUMBER, ETC.

8. CITY - PROVINCE OR STATE

9. COUNTRY AND POSTAL CODE

10. FATHER'S NAME

11. MOTHER'S NAME

12. ONE EMAIL ADDRESS

13. ONE TELEPHONE NUMBER

14. ONE WECHAT or WHATSAPP ADDRESS FOR A PARENT

15. STREET ADDRESS

16. BUILDING NUMBER , APARTMENT NUMBER, ETC.

17. CITY - PROVINCE OR STATE

18. COUNTRY AND POSTAL CODE

19. STUDENT'S MOBILE PHONE:

20. EMAIL ADDRESS

21. WHATSAPP

22. SKYPE

23. WECHAT

24. FACETIME

25. KAKAOTALK

26.

27. IELTS: SCORE / DATE TAKEN

28. TOEFL: SCORE / DATE TAKEN

29. PTE: SCORE / DATE TAKEN

30. ANY OTHER TESTS? (NAME OF TEST) SCORE DATE TAKEN

31. DATE GRADUATED FROM HIGH SCHOOL

32. IF YOU HAVE TAKEN UNVERSITY COURSES, PLEASE DESCRIBE THEM

33. COURSES OF STUDY AVAILABLE: PLACE AN "X" NEXT TO ALL THAT APPLY

34. WOULD YOU TAKE ONE SEMESTER OF ESL TO FACILITATE ENTRY INTO YOUR PROGRAM?

35. TELL US WHAT WILL DRIVE YOUR DECISION THE MOST: PLACE AN "X" NEXT TO EACH QUESTION THAT REPRESENTS YOUR ANSWERS

PROGRAM DESIRED