ELI Placement Form - Spring 2022

ELI Placement Test (ELIPT) - Fall 2026 Registration Form
This form has 5 parts, and should take about 10 - 15 minutes.

Please complete all 5 parts, giving as much information as you know. If there is anything you do not know, please leave that information blank. Some information, such as your UH ID number, should be on your letter of acceptance from the university.

By providing as much information as possible, this will help us determine the most accurate placement for you. Thank you.
Part 1: Personal Information
Family name (last name) *
Given name (first name)*
UH Student ID*
Gender
Home country (country of origin)*
Native languages*
Primary email address (@hawaii.edu)*
Secondary email address
Part 2: UH-Manoa Student Information
Semester admitted*
Visa status*
Student status*
(Undergraduate) Major*
(Undergraduate) Advisor's name
(Undergraduate) Are you a Student Athlete?

YesNo
(Undergraduate) If you are a Student Athlete, which sport do you play?
(Undergraduate) If you are a Student Athlete, who is your Student Athletic Advisor?
(Graduate) Degree you are seeking*
(Graduate) Field of study*
(Graduate) Advisor's name*
(Graduate) Have you been offered an assistantship?

Part 3: Experience in English-Speaking Counties
Time spent in English-speaking countries:
Country (months/years)
Schooling in English-speaking countries:

Please include the name of school, location, month/year you began school, month/year you finished, and what degree you earned (if any). For example:

Roosevelt High School, Honolulu, HI, from 08/2015 to 05/2019.
Schooling in English-speaking countries
Schooling in English-speaking countries
Schooling in English-speaking countries

Part 4: TOEFL, IELTS or Other English Test Scores
Test(s) Taken

TOEFL (internet-based)TOEFL (computer-based)TOEFL (paper-based)DuolingoIELTS
TOEFL Total Score
Listening subscore
Speaking subscore
Reading subscore
Writing subscore
Duolingo Total Score
IELTS Total Score
Listening subscore
Speaking subscore
Reading subscore
Writing subscore
______________________________________
SAT Critical Reading
ACT Reading
ACT English

Final Part: Placement Test date
ELIPT Testing Date*

August 18th - From 12:30pm to 3pmAugust 19th - From 12:30pm to 3pm* (*MIX Students should sign up for this test)August 25th - From 10:30am to 1:00pm
If you need special assistance for the exam due to a disability, please check the box below and contact a Kokua counselor as soon as possible.
Will you be contacting Kokua for special assistance?

Yes
Make sure all information is accurate and detailed to the best of your ability.
After successfuly submitting your form you will see a "thank you" message.
Should be Empty:

ELI Placement Test (ELIPT) - Fall 2026 Registration Form