Application Form

International Student Application Form
Contact Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age*
Gender*

MaleFemale
Country of Birth*
Nationality*
Passport Number*
Country of Issuance*
Expiration Date*

MonthDayYear
Date
Home Country Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
US Address (If currently living in US)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Whatsapp
Email*
example@example.com

Program Information
Type of Enrollment*
Preferred Location*
Preferred Shift*
Academic Calendar 2023
Program Start Date*

MonthDayYear
Program End Date*

MonthDayYear
Length of Program*
How did you hear about us?*

GoogleInstagramFacebookFriendOther
Will you include any of your legal dependents in your F-1 Application?

YesNo

Dependents Information
If yes, please specify from the following

SpouseChildren
Spouse Name

First NameLast Name
Date of Birth

MonthDayYear
Nationality
Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Nationality
Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Nationality
Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Nationality

Declaration of Finances
Life USA Orlando is required by the U.S. Government to determine whether you have adequate funding for tuition, fees and living expenses for the duration of your stay.

You must show proof of balance of US$13,000/year or US$1,100/month.

Dependents: US$4,000/year or US$350/month.

Financial sponsors must sign the Affidavit of Financial Support to verify they are willing to use their funds for the student’s educational expenses. The Affidavit of Financial Support is an official document and must be notarized by a notary public.

Bank Statement: You or your sponsor must provide a statement or bank letter showing the total amount needed in US$ dollars or in the currency where the account is held. The sponsor on the Affidavit of Financial Support and the account holder on the bank statement must be the same.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Number of Dependents (Spouse and Children)
Student's Declaration.*

I hereby promise that the information provided is correct and complete. I understand that I am ultimately responsible for all expenses associated with my stay in the Unites States.
Signature*

Clear
Date*

MonthDayYear
Date
Do you intend to use a sponsor to finance your studies?

YesNo
Copy of Bank Statements*

Cancelof

Affidavit of Financial Support
The affidavit below must be completed by the student’s sponsor. Students do not need to complete this form if all the financial support comes from their own personal funds.

Bank Statement: Sponsor must provide a statement or bank letter showing the total amount needed in US$ dollars or in the currency where the account is held. The sponsor on this Affidavit of Financial Support and the account holder on the bank statement must be the same.
To be completed by the sponsor:

Relationship to the student:   Relationship
I hereby certify that I,   First Name*   Last Name* (name of sponsor) will be responsible for the educational expenses of First Name*   Last Name* (name of student).

I certify that the total amount of money I have available for the student’s educational expenses at Life USA Orlando is   Amount (American dollar)*.

I authorize the release of my supporting financial documents to verify that the promised financial resources are immediately available to me and the student. I swear and affirm that I know and understand the contents of this affidavit, signed by me that they are true and correct.

Signature of Sponsor:   Signature*

Date:   Date*
Copy of Sponsor's Personal ID and Bank Statements*

Cancelof

Enrollment Agreement
Student Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Type of Enrollment*
Program Start Date*

MonthDayYear
Program End Date*

MonthDayYear
Length of Program*
Prices Initial 4 months
Prices Initial 6 months
Prices Initial 12 months
Prices School Transfer 4 months
Prices School Transfer 6 months
Prices School Transfer 12 months
Change of Status
Signature*
Date*
Copy of Student's Passport and Dependents*

Cancelof
Copy of Student's I-20 and Dependents*

Cancelof
Copy of Student's Visas, I-94 and Dependents*

Cancelof

Acknowledgement

For Parents and Guardians Only
Parent / Guardian Name*

First NameLast Name
Date of Birth

MonthDayYear
Relationship*
I have received, read, and understood Life USA Orlando Terms and Conditions, School Policies and Attendance Policy. I know that it is my responsibility to keep in accordance with these policies and that if I do not, that my I-20 is in danger of termination without notice.

I also understand that if my level of English proficiency is not to the point that I can understand this or neither school’s official documents, then it is my responsibility to get someone to read this to me in my native language so that I can understand it.

I understand that if I move, I MUST update my current living address whenever there are any changes.

I also understand that if the minor student is sick, I must contact the P/DSO immediately to arrange to provide appropriate medical documentation from a licensed medical physician, doctor of osteopathy, or licensed clinical psychologist to be considered as an excused absence. Failure to prove this documentation will result in absences, and possibly put my I-20 in danger.

Finally, I understand that I am responsible for knowing the policies and procedures of Life USA Orlando and to follow them completely. If any policies or procedures change, it is my responsibility to check my email to ensure that I am aware of the changes. I do not have to sign a new waiver to account for the change in policy or procedure.
Signature*

Clear
Date

MonthDayYear
Date
Copy of Parent/Guardian Passport or ID*

Cancelof

Waiver of Liability
Students applying for the Change of Status process will be assisted by a third party company or a professional that is not related to Life USA Orlando nor to any of Life USA Orlando’s employees. Life USA Orlando is not liable for any approval, denial or any issue caused by the third party company chosen.
I also agree to INDEMNIFY AND HOLD Life USA Orlando HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my Change of Status process and to reimburse them for any such expenses incurred.

In consideration of deciding to apply for the Change of Status process, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue Life USA Orlando, its officers, employees, and agents from liability from any and all claims including the negligence of Life USA Orlando, its officers, employees and agents regarding services rendered provided by the third party doing my Change of Status process.
Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date

Acknowledgement for Change of Status Process
Nonimmigrants who have been lawfully admitted to the United States and maintain the status in which they were admitted (or previously changed to) may seek to change from one visa classification under to another, with certain restrictions. The applicant must meet all eligibility criteria for the new visa classification.
I, a nonimmigrant applying to change to F-1 status, am aware that to be eligible for a change of status process I must:
- Be lawfully admitted to the United States in a nonimmigrant status;
- My nonimmigrant status remains valid; and
- I have not violated the conditions of my nonimmigrant status.
I am aware that is my full responsibility, in case my F-1 application has not been approved before the program start date reflected on the initial “Certificate of Eligibility for Nonimmigrant Student Status” (Form I-20), I must contact and request my Designated School Official (DSO) to defer the program start date in the Student and Exchange Visitor Information System (SEVIS) before the current program start date has been reached.
I, * have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the Change of Status process. I hereby assert that my option is voluntary and that I knowingly assume all such risks.
Signature*

Clear

Thanks for Applying!

Submit your form and the Admission Team will make contact to you shortly.
Should be Empty:

International Student Application Form

Contact Information

Program Information

Dependents Information

Declaration of Finances

Affidavit of Financial Support

Enrollment Agreement

Student Information

Acknowledgement

Waiver of Liability

Acknowledgement for Change of Status Process

Thanks for Applying!