How do I apply?

Print the following application form, fill it out, and mail it to:

E.S.L. Program or Office of Admissions
Coe College
1220 First Avenue N.E.
Cedar Rapids, Iowa 52402 U.S.A.

Application for Admission (Please print this and mail it)

(Family Name)____________________________________________

(First)_________________________(Middle)___________________

Current Mailing Address: ____________________________________

__________________________________________

Current Telephone: ________________________________________

E-Mail Address: __________________________________________

Date of Birth: (Month)_________ (Day)________ (Year) __________

Country of Birth __________________________________________

Country of Citizenship______________________________________

Male ____ Female ____

Single ____ Married______ Number of Dependents ________

I wish to begin my studies in: __________Fall (August)

_________Spring (January)  __________Summer (June)

_________ Other (Please specify)

Proposed Major ________________________________________

Have you taken the TOEFL test? _______yes _______no

Score ________ Date _______________________

School Record: List the name of your high school and the date of graduation.

_____________________________________________

Personal or Family Support

Please submit both of the following:

1) Letter of full financial support from parent or relative (Letter must be signed.)

2) Certified bank statement to include the following about your savings account:

Name of bank: __________________________________________

Location: ______________________________________________

Amount in US dollars: ____________________________________

Certification by bank official: This is to certify that the information furnished by the applicant on this form regarding his/her personal savings is a true and accurate statement.

Bank official's name: ______________________________________

Title: __________________________________________________

Bank official's signature: ___________________________________

Official bank seal:

Date: _________

Please sign the following statement:

I hearby certify that the information in this application is correct.

Student name _________________________________________________

Student signature ______________________________________________

Date _______________________________________________________

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