IEP Part-Time Registration

Please complete this form for part-time admission into West Virginia University's Intensive English Program.

First Name (Given Name) *

Exactly as it appears on your passport.
Last Name (family Name) *

Exactly as it appears on your passport.
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number *
Email *
Gender *
Male Female Other
Date of Birth * / MM / DD YYYY
Citizenship Status *
Race
(1) American Indian or Alaska Native (2) Asian (3) Black or African American (4) Native Hawaiian or other Pacific Islander (5) White
Please select all that apply.
Ethnicity
Visa Type *

Please select the visa type with which you currently entered the United States.
City of Birth *
Country of Birth *
Country of Citizenship *
Country of Permanent Residence *
Native Language *
Have you taken the TOEFL or IELTS exam? *
No Yes (Please list the date taken and score received.)
Please upload a copy of the photo page of your passport. (10MB max) pload a File *

Attach Files
COURSES AND PAYMENT

Please select the number of courses in which you intend to participate. Please note the cost associated with each number of courses..
How many courses do you intend to take? *
One Course - $1,024 Two Courses- $2,048 Three Courses- $3,072 Four Courses- #4,096
This amount does not include applicable fees.
Which Semester do you plan to enroll in the IEP? *
Summer 2020 Fall 2020 Spring 2021
STATEMENT OF COMMITMENT: By agreeing to this statement I understand that I will be financially and academically committed to the Intensive English Program. I am responsible for all program charges that will be billed to me, and I am responsible for paying those charges in accordance with West Virginia University's payment deadlines. *

IEP Part-Time Registration

IEP Part-Time Registration

COURSES AND PAYMENT