Boston School of Modern Languages
English Instruction Since 1925

Application Form

Complete the Form

Fields marked with an asterisk * are required

Personal information

* First Name:
* Last Name:
* Date of birth (mm/dd/yy)
* Age:
* Country Of Birth:
* Country of Nationality:
* Sex:
Profession:
Company:
Years of English instruction?

Please enter your mailing address:
* Address
* City:
* State:
Postal Code:
* Country
* Telephone:
Cellular Phone:
Fax:
* E-Mail:
* Verify your E-Mail:

Courses

Select the course you would like to register for.

Group Instruction
Number of Weeks:
Lessons per Day: (Lessons are 50 minutes)

Private Instruction
Number of Weeks:
Private Lessons (per day) (Lessons are 50 minutes)

* Students requesting I-20's must take a minimum of 5 classes each day.

Individual Private Instruction available at $60 per class in any combination with group lessons, $75 for less than 5 classes per week, or separately Business English Private instruction available at $90 per class in any combination with group lessons or separately.

Select your Starting Date
Note: If you are at an intermediate level or higher, you may start on any Monday.
* I need I-20 Form for a Student Visa: Yes No I will be transfering from
another school in the U.S.

* After you complete your
English course, are you planning to
study in an American university?
Yes No

Additional Services

Airport Pick-up:

Airport Drop-off:

Activities Program:
Number of Weeks:
Activities are Monday to Friday and do not include weekend activities.

Health Insurance* ($25 per week):
*Insurance or proof of coverage in the US is mandatory.

CADIVI Processing fee* ($150):
*Applies only to students from Venezuela.

Housing options

* Do you require housing? Yes No
Apartment
Shared Student Apartment (21 years old and over)
Shared Room
Private Room
Private Student Apartment (21 years old and over - subject to final reservation confirmation)
Number of People
Number of Beds
Executive Apartment (subject to final reservation confirmation)
Number of People
Number of Beds
Homestay
Homestay
Shared Room
Private Room
Additional comments or questions:
* BSML makes every effort to accommodate your preferences. Students should anticipate shared room accommodation during our high season.

Tuition

Person or Company Responsible for Tuition
Name:
Title:
Company Name:
Address:
City:
State:
Postal Code:
Country:
Telephone:
Fax:
E-mail:
Relationship:

Local Contact Person (If applicable)
Name:
Address:
City:
State:
Telephone:

Contact at BSML

*
Please select your contact person at
Boston School of Modern Languages
Name:
Other:

Deposit

- US $250.00 Enrollment Fee (non-refundable)
- US $150.00 Housing Placement Fee if you have requested Homestay or Apartment (non-refundable)
- US $90.00 charge for express mail when I-20s are required.

Total US $490.00 Deposit

Online registrations must be paid by credit card only. For other payment options please visit How to enroll at BSML

Registration Payment

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814 South Street, Boston, MA 02131, USA | Tel: +1 617-325-2760 | Fax: +1 617-325-2763 © 2014 BSML, Inc.