Missouri State University
English Language Institute - Preparing for a New World!
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CONTACT

Jim D. Morris Center for
Continuing Education
301 S. Jefferson Ave, Springfield, MO 65806
Phone: 417-836-6540
Fax: 417-836-4784
JaneRobison@missouristate.edu
eli.msu@gmail.com

   


Online Application
 
 

Four easy steps to apply:
1. Submit the completed online application form.
2. Send or fax an official statement from the bank which specifies in US dollars the   

    amount of money available for language training. (Click here to see the exact dollar

    amount).
3. Non-refundable $100 application fee which includes the express-mail fee (This fee

    may be paid by credit card or cashier's check).
4. A copy of the passport.
   
 
  Please complete the entire form.
 
APPLICATION TERM
  For what term are you applying?
  
   
PERSONAL INFORMATION  (As it appears in your passport)
 
Family Name:

  Given Name:  
Middle Name:

  Date of  Birth:  
 

Country of   Citizenship:  

Country of Birth:

  Native    Language:  
 


(e.g 123-45-6789)

   Gender:  
E-Mail Address:
   
  If married, will your spouse accompany you?    Yes   No
If yes,
 
Family Name:

Given Name:  

Middle Name:

Date of Birth:  

Country of Birth:

Country of   Citizenship:  

   
    Yes       No
If yes, child 1
 
Family Name:

Given Name :
Middle Name:

Date of Birth :
Country of Birth:

Country of   Citizenship :
    Gender:      
   
Child 2
 
Family Name:

Given   Name :
Middle Name:

Date of   Birth :
Country of Birth:

Country of   Citizenship:
    Gender:    
   
  Child 3
 
Family Name:

Given Name:
Middle Name:

Date of Birth:
Country of Birth:

Country of  Citizenship:
    Gender:    
  Child 4
 
Family Name:

Given Name:
Middle Name:

Date of Birth:
Country of Birth:

Country of  Citizenship:
    Gender:    
PERMANENT ADDRESS
 
Outside USA:
City:  State or Province:
Country:  Postal Code:
 

City:  State:

Zip:

 
 

   
  MAILING ADDRESS  (where you want us to mail your                                      documents)
 
 
City:  State or Province:
Country:  Postal Code:
 
PARENT OR GUARDIAN INFORMATION (If you are under 18)
 
    Gender: 
ACADEMIC INFORMATION
 

Secondary School
School Name:

        Location:  

University

School Name: Location:  
 
MISCELLANEOUS INFORMATION
 
Do you want to apply for a F-1 visa?    (If yes, we will send you the I-20 form.)
If you are already in the U.S.A., which visa do you have?         
 
If you are a transfer student, give the name and address of the institution that issued your I-20:
Name of University   
City:  State or Province:  

 Postal Code:  
Transfer Students are required to complete this Transfer Form. (Download Form)
After you complete the ELI, you will:
 

 Major:
Other: 

If you have taken the TOEFL Test, please provide the date and  score of the most recent test:

  How did you learn about the ELI?
 
 
Other: 
APPLICATION VERIFICATION
 

 •  The information I entered on this application is correct and complete.
 •  If I am accepted, I will arrive at Missouri State University prior to the

    beginning date on the form I-20.
 •  I understand that I must have sufficient funds for tuition and living expenses during my

    entire stay at Missouri State University.
 •  I understand that admission to the English Language Institute is not the same as

    admission to Missouri State University.
 •  I understand that I must take the Institutional Placement Test after I arrive and that I

    must enroll in the required English courses. I also understand that I may need to study

    for more than one semester before I reach the proficiency level required for university

    study.
 •  I give permission for the English Language Institute to provide information about my

    English proficiency, progress, and attendance to the appropriate faculty members and

    administrators of Missouri State University.
   
 
   
 

   
   
 

REMEMBER!
 
To ensure prompt processing of your application, please include the following:
 •  Completed application form
 •  An official statement from the bank which specifies in US dollars the amount of
    money available for language training (Fax to 417-836-4784)
 •  Non-refundable $100 application fee  (This fee may be paid by credit card or
    cashier's check. The application fee includes express delivery of the I-20.)
 •  A copy of the passport.  
   
   
 

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Missouri State University, Jim D. Morris Center for Continuing Education :: Copyright 2002