ACE Application for F1 Change of Status

I have a financial sponsor.*

YesNo

Sponsor's Name

First NameLast Name
Sponsor's Relationship to Student
Sponsor's Address
Sponsor's Phone Number with Country Code
Sponsor's Email
example@example.com

I attest that I have read and understood the information contained in this I20 Request Form. I further attest that the information provided on this I20 Request Form by me (the student) and my sponsor (if applicable) is accurate and true, that the funds are available without restrictions and transferable to the U.S. to meet my financial obligations to the Institute for Academic and Career English, LLC. I affirm that I am personally responsible for all costs associated with my education and living expenses.*

Powered by Jotform SignClear
Name*

First NameLast Name
Date*

MonthDayYear
Date

I will travel alone.*

YesNo

I will travel with my spouse.

YesNo

Spouse's Information
Name (Spouse)

First NameLast Name
Birthdate (Spouse)

MonthDayYear
Date
City of Birth (Spouse)
Country of Birth (Spouse)
Citizenship (Spouse)
Email (Spouse)
example@example.com
Address IN HOME COUNTRY (Spouse)
Phone number IN USA (Spouse)

I will travel with minor dependents (my children under 21 years of age).

YesNo

Minor Dependent Information

Biographical information for first child
Name

First NameLast Name
Birthdate

MonthDayYear
Date
City of Birth
Country of Birth
Citizenship
I will travel with additional children under 21 years of age.

YesNo

Minor Dependent Information

Biographical information for third child
Name

First NameLast Name
Birthdate

MonthDayYear
Date
City of Birth
Country of Birth
Citizenship
I will travel with additional children under 21 years of age.

YesNo

Please enter biographical information for additional children here.

Emergency Contact Information

Please give information about who ACE can contact in case of an emergency in which the student requires immediate medical attention.
Name of Emergency Contact*

First NameLast Name
Relationship to Student*
Ex: mother, father, husband, wife, friend, etc.
Emergency Contact's Phone Number*
Please enter a valid phone number.

Attendance Policy

Students at ACE may not miss more than 12 clock hours of scheduled class in one term.

A student who misses more than 12 clock hours of scheduled class in one term
is at risk of termination due to unauthorized drop below full course.

According to SEVP, a student whose I20 is terminated must either
leave the United States immediately or
apply for reinstatement by applying for admission at a different SEVP-certified school

TO AVOID TERMINATION

Schedule all appointments, events and commitments
for days and times you are not in class.

Complete missing hours by attending tutoring sessions
in the same week you are absent.

Do not leave campus during scheduled class time.
Any time off-campus during school hours is considered an absence.

DO NOT MISS MORE THAN TWELVE HOURS OF CLASS IN A TERM.

Students may not “bank hours” by clocking in for more than 18 hours in one week.
I understand and agree to comply with the Institute ACE F1 Attendance Policy.*

Powered by Jotform SignClear

Media Release and Consent

By participating in ACE activities, you consent to let ACE use your image, voice, etc.
In consideration for participating in a subsidiary of J. Johnson Holdings, LLC, I hereby give consent to J. Johnson Holdings, LLC and its subsidiaries to use my name, photograph, voice, recording, comment, statement, or other likeness for print media, website, television, radio, video, promotional materials, electronic or print newsletters, online news distribution and similar mediums (the “Production”).

Such use of the Production is granted to J. Johnson Holdings, LLC and its subsidiaries throughout the world for use by J. Johnson Holdings, LLC and its subsidiaries in whatever manner it may desire, and may be copied, copyrighted, edited and distributed by J. Johnson Holdings, LLC and its subsidiaries in any medium in perpetuity without any compensation to me. Furthermore, I hereby consent that any such Production shall be the exclusive property of J. Johnson Holdings, LLC, and J. Johnson Holdings, LLC shall have the right to use, sell, publish, print, display, distribute, duplicate, reproduce, reprint, broadcast, create derivative works, and make other uses of such Production as J. Johnson Holdings, LLC may desire, free and clear of any claims whatsoever from me. I agree that J. Johnson Holdings, LLC can use the Production, in whole or in part, without restrictions as to changes or alterations. I also hereby expressly agree by this Media Release and Consent that the Production shall be considered, a work made for hire (if applicable), and J. Johnson Holdings, LLC shall own all copyrights in and to the Production.
I understand and agree to comply with the Institute ACE Media Release Policy.*

Powered by Jotform SignClear
Record Retention

Institute ACE will securely collect and maintain student information necessary to record a student’s application, progress and final award in the program and to comply with legal requirements such as visa reporting requirements. This information will be retained for six years, after which it will be securely disposed of by Institute ACE with the exception of the student’s name, dates of attendance, final level achieved, and immigration-related documents required by SEVIS to be kept for three years after completion of the program.

Health Insurance and International Students

Visits to the doctor and/or hospital is extremely expensive in the US.

ACE recommends but does not require the purchase of health insurance.

Because of the extremely high cost of many healthcare services and prescription medications in the United States, Institute ACE strongly recommends that international students purchase a health insurance policy. However, as there is currently no federal requirement for F-1 visa holders or their F-2 visa-holding dependents to have health insurance while in the United States, Institute ACE does not currently require students enrolled in our classes to have a health insurance policy. (At this time, F-1 (OPT) visa holders are required to maintain the minimum essential coverage.) International students should be aware that health insurance regulations may change during their time here, and the Institute ACE policy may change accordingly. International students may be surprised that the cost of medical care without insurance can be very, very expensive. The US healthcare system may differ greatly from the healthcare system in their home country, and students should familiarize themselves with the healthcare and insurance options available in order to make wise decisions.

Where to Go for Medical Treatment

For life-threatening medical emergencies, call 911 or go directly to the nearest emergency room hospital. However, ambulance rides and emergency room hospital visits can be very costly, even with insurance. Urgent care facilities are often a good option for serious medical needs that are not life-threatening.

Visiting a doctor’s office can be an affordable option if your health insurance policy covers all or part of the cost of the visit. However, visits to the doctor’s office require the scheduling of an appointment in advance and it can sometimes take a few days to get treatment.

Walk-in clinics, available in some pharmacies, can be a good option for students needing immediate care for non-emergency illnesses and injuries. Many insurance policies will cover all or some of the care you receive at walk-in clinics. It is always wise to confirm the costs and your coverage before receiving care, to avoid unpleasant surprises when the bill arrives.
I understand that health insurance is strongly recommended by Institute ACE. I understand that I am responsible for obtaining my own health insurance. Institute ACE takes no responsibility for health insurance.*

Powered by Jotform SignClear

Fees and Supporting Documents

Please upload documents here or email to admissions@instituteace.org
Students who are applying for a Change of Status must make a nonrefundable tuition deposit of $300 before the application will be processed. The deposit is payable here: https://www.instituteace.org/pay-for-english-courses/p/change-of-status-deposit
Application processing fees are payable here: https://www.instituteace.org/pay-for-english-courses
Passport identification page(s)

Cancelof
Bank Statement

Cancelof
Should be Empty:

I20 Request for Students applying for a Change of Status (applying from within the US).

Spouse's Information

Minor Dependent Information

Minor Dependent Information

Emergency Contact Information

Fees and Supporting Documents