Samford University

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Intensive English Program (IEP) Application

It's easy to apply to the ELLI. No TOEFL score is required.  We accept applications anytime! 

 

    General requirements:  

  • Age: 17 or older
  • Education: Completed high school
  • Prior English knowledge: desirable

 


 ATTENTION ALL APPLICANTS

 

Students requesting Samford visa sponsorship: In order to complete your application packet, please see the ELLI Application Instructions and Checklist page and make sure you have collected and completed all forms and supporting documents.  You must also complete the Financial Affidavit Form.  Send your completed application packet to: English Language Learner Institute Samford University 800 Lakeshore Drive Birmingham, AL 35229 205-726-4208

 

Students already living in the Birmingham area or not requesting Samford visa sponsorship: You do not need to provide financial information.

 


Intent of study information:

How did you learn about our program?   

After English studies you will:

   

 

If studying for a degree at Samford, what level? 

   

If studying degree at Samford, what will be your major of study?   

If studying in our IEP Certificate track, will you study full-time or part-time? 

   

Please select entry term: 

   

Applicant Information:

Family Name: 

Given Name(s): 

Sex: 

   

 

Date of Birth: 

Native Language: 

Race: (Check all that apply) 

   

 

Marital Status: 

   

 

Country of Citizenship: 

Country of Permanent Residence: 

Country of Birth: 

Foreign Address:   

Current Mailing Address:   

Local Address:   

Email address: 

Secondary Email address: 

Telephone: 

Emergency Contact Name: 

Emergency Contact Number: 


Education:

List your previous schools:

Name of High School:   

Address of School:   

Language of Instruction: 

G.P.A.: 

First Attended: 

Last Attended: 

Graduated: 

   

 


Name of School:   

Address of School:   

G.P.A.: 

First Attended: 

Last Attended: 

Graduated: 

   

 


Name of School:   

Address of School:   

G.P.A.: 

First Attended: 

Last Attended: 

Graduated: 

   

 

*Please provide proof of education by submitting ONE of the following: proof of secondary/high school education OR official copy of graduation certificate, OR university transcript.


Have you taken the ACT or SAT? 

   

 

If yes, what are the dates & scores?

i. ACT Date/Score: 

ii. SAT Date/Score: 

Have you taken the TOEFL, TOEFL- IBT or IELTS? 

   

 

If yes, what are the dates & scores?

i. TOEFL: Date/Score: 

ii. TOEFL-IBT: Date/Score: 

iii. IELTS: Date/Score: 

*If you have taken one or more of these tests, please provide copies of subscores.


Immigration Information:

Are you currently in the U.S? 

   

 

If yes, what is your current immigration status? i.e. F visa, J visa, Permanent Resident, Asylum, etc. *Please include a proof of your immigrant status. 

Are you transferring from another U.S. school? *If yes, please complete and include a Transfer Clearance Form

   

 

Do you intend to bring dependents with you to the United States? 

   

 

If yes, please select who will be coming with you: 

   

 

 

Samford University is an Equal Opportunity Institution that complies with applicable law prohibiting discrimination in its educational and employment policies and does not unlawfully discriminate on the basis of race, color, sex, age, disability, veteran status, genetic information, or national or ethnic origin.

 

 

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