ESL Program Online Application

  • ESL Program Online Application

    This application is for new and transferring students under Long-term Study Abroad (Student Visa), Short-term Study Abroad (ESTA, etc.), and Kama'aina (Green Card holders / U.S. Citizens).Your application will be complete once you fill out this form, submit the required documents, and complete the payment.
  • Date of Birth*
     - -
  • Gender on your passport*
  • Format: (000) 000-0000.
  • Course*

  • Long-term Study Abroad (Student Visa / F1 Visa: I-20)

    This section is for applicants who are applying for a new F1 Student Visa or transferring from another school.
  • Do you already have a valid F-1 Visa?*
  • Do you have dependents who will apply for an F-2 Visa?*
  • Are you transferring from another school?*
  • Last Day of Study at Current School
     - -

  • General Questions for All Applicants

    Please note that some sections of this form will be automatically skipped for applicants under Short-term Study Abroad / Non-Student Visa (ESTA, E Visa, etc. / Non I-20) or Kama'aina (Green Card holders / U.S. Citizens). Please proceed with confidence.
  • Format: (000) 000-0000.
  • Intended Start Date for ESL Program*
     - -
  • Accommodation Status
  • Accommodation Interests / Preferences

  • 【Academia's Share House】$100 / night + $100 Initial Fee + $60 Cleaning Fee (plus tax) + $300 Security Deposit (Refundable)
    Capacity: Up to 1 adult and 2 children. (Additional guests: +$50 per person)
    Guardian Fee: $100 / week for students in high school or younger (Includes breakfast and dinner).
    Location: Ala Moana area.
    Amenities: Private room, bathroom, and shower. Shared laundry.
    Duration: Maximum stay of 3 months.

    【Homestay / Condo (Short-term & Vacation Rental)】We will provide recommendations from our partner network based on your preferred dates and budget.

  • Preferred Check-in Date
     - -
  • Preferred Check-out Date
     - -

  • Please Read and Acknowledge

    Please read and agree to the terms.

  • ・I understand that Academia Language School has the right to change policies, prices and programs without prior notice.

    ・I certify that the information provided on the application form is correct. 

    ・I will be responsible for reading, understanding, and accepting all school policies. I further agree to all terms and conditions provided by Academia Language School.

    ・I have read, understand and agree to Academia's Refund Policy.

    ・If a student is under 18 years old, then a legal guardian must sign on behalf of the student.）

  • Date Signed*
     - -
  • Did you see our promotion on any of the following websites?
  • Should be Empty: