Academic English Registration Form: Spring 2013

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Academic English Registration Form Spring 2013

Student Name Phone Email Date of Birth

Ciprian Ionut Zub 339-226-1984 zub.ciprian@yahoo.com 06/22/1989


Skokie
8930 Gross Point Rd Skokie IL 60077 847.967.5030

Address City State Zip

339-226-1984 Chelsea MA 02150

29 East Madison St Chicago, IL 60602 312.470.1114

Chicago

477 East Buttereld Rd Lombard IL 60148 847.400.0066

Lombard

I Charlestown 529 Main St

Charlestown MA 02129 781.313.8190

10 Mechanic St Worcester MA 01608 774.317.6900

Worcester

Course(s)
ESL Academic English Small Group Discussion America Through Academic Readings Writing Student Newspaper
Spring 2013 Academic English Programs: Choose classes at your Pre-approved Course

Start Date
4/8/2013

End Date
6/23/2013

Skokie Campus
Section 1 2 3 Tue/Thu 5pm-10pm Tue/Thu 5pm-10pm Sat/Sun 9am-2pm ESL421 Academic English Small Group Discussion ESL413 Academic English America Through Academic Readings ESL419 - Academic English Writing Student Newspaper Room 230 210 210

Chicago Campus
1 2 Tue/Thu 5pm-10pm Sat/Sun 9am-2pm ESL419 - Academic English Writing Student Newspaper ESL413 Academic English America Through Academic Readings 215 216

Lombard Campus
1 Tue/Thu 5pm-10pm ESL413 Academic English America Through Academic Readings 40

Mon/Wed 5pm-10pm

Charlestown Campus
ESL419 - Academic English Writing Student Newspaper 203

Spring 2013 Lab Offerings: Choose 2 Labs from the list below
Skokie Campus Lab Schedule
Section Lab Schedule Section Lab Schedule

1 2 3 4 5 6 7 8

Monday 9am 1pm Monday 1pm 5pm Monday 5pm 9pm Tuesday 9am 1pm Tuesday 1pm 5pm Tuesday 5pm 9pm Wednesday 9am 1pm Wednesday 1pm 5pm

10 11 12 13 14 15 16 17

Thursday 9am 1pm Thursday 1pm 5pm Thursday 5pm 9pm Friday 9am 1pm Friday 1pm 5pm Saturday 10am 2pm Saturday 2pm 6pm Sunday 10am 2pm

Document Integrity Verified

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9
Section

Wednesday 5pm 9pm


Lab Schedule

18 Sunday 2pm - 6pm Chicago Campus Lab Schedule


Section Lab Schedule

1 2 3 4 5 6 7 8 9
Section

Monday 9am 1pm Monday 1pm 5pm Monday 5pm 9pm Tuesday 9am 1pm Tuesday 1pm 5pm Tuesday 5pm 9pm Wednesday 9am 1pm Wednesday 1pm 5pm Wednesday 5pm 9pm
Lab Schedule

10 Thursday 9am 1pm 11 Thursday 1pm 5pm 12 Thursday 5pm 9pm 15 Saturday 10am 2pm 16 Saturday 2pm 6pm 17 Sunday 10am 2pm 18 Sunday 2pm 6pm Lombard Campus Lab Schedule
Section Lab Schedule

1 2 3 4 5 6 7 8 9
Section

Monday 9am 1pm Monday 1pm 5pm Monday 5pm 9pm Tuesday 9am 1pm Tuesday 1pm 5pm Tuesday 5pm 9pm Wednesday 9am 1pm Wednesday 1pm 5pm Wednesday 5pm 9pm
Lab Schedule

10 Thursday 9am 1pm 11 Thursday 1pm 5pm 12 Thursday 5pm 9pm 15 Saturday 10am 2pm 16 Saturday 2pm 6pm 17 Sunday 10am 2pm 18 Sunday 2pm 6pm Charlestown Campus Lab Schedule
Section Lab Schedule

1 2 3 4 5 6 7 8 9

Monday 9am 1pm Monday 1pm 5pm Monday 2pm 6pm Tuesday 9am 1pm Tuesday 1pm 5pm Tuesday 2pm 6pm Wednesday 9am 1pm Wednesday 1pm 5pm Wednesday 2pm 6pm

10 Thursday 9am 1pm 11 Thursday 1pm 5pm 12 Thursday 2pm 6pm 13 Friday 9am 1pm 14 Friday 1pm 5pm 15 Friday 2pm 6pm 16 Saturday 10am 2pm 17 Saturday 2pm 6pm 18 Sunday 10am 2pm 19 Sunday 2pm 6pm Worcester Campus Lab Schedule
Section Lab Schedule

Section

Lab Schedule

1 2 3 4 5 6 7

Monday 2pm 6pm Tuesday 9am 1pm Tuesday 1pm 5pm Tuesday 5pm 9pm Wednesday 2pm 6pm Thursday 9am 1pm Thursday 1pm 5pm

8 9 10 11 12 13 14

Thursday 5pm 9pm Friday 9am 1pm Friday 1pm 5pm Saturday 10am 2pm Saturday 2pm 6pm Sunday 10am 2pm Sunday 2pm 6pm

Enter the Campus and Section Number in the spaces provided below:
LAB1 LAB2 Campus Campus

Charlestown Charlestown

Section Number Section Number

All class/lab/schedule changes are subject to a $25 late fee effective April 2, 2013. No class/lab/schedule changes are allowed after April 22, 2013.
All class/schedule changes must be submitted to the Registrar Office for approval. Students may not switch classes without notification of the Registrar Office. Courses and instructors are subject to change by CSI without notice. Classes may be cancelled due to poor enrollment. Any questions about possible changes may be directed to the Registrars Office.
Document Integrity Verified
EchoSign Transaction Number: TCYGV62M2S5P4P

Application Procedures: If you are taking a course(s) for the first time at CSI, contact the International Student Services Office for information regarding Admissions Application, 847.967.5030, meet with a CSI Admissions Representative, and complete the admissions process. After being accepted to CSI, register for each academic term by following the registration procedures. Registration Procedures: Complete this Registration Form. Payment of tuition and academic fee is required at the moment of registration. Cancellation: If you decide to cancel your registration you must notify the International Student Services Office. Failure to cancel will result in full financial responsibility for tuition charges. Refunds on tuition after classes begin are subject to CSI Refund Policy. Withdrawal Policy All requests to drop a class or withdraw must be submitted in writing to the Office of the Registrar in a timely manner. Nonattendance of courses does not necessarily relieve students of their financial obligation. Course Load Policy F-1 students must enroll in full course load of 18 classroom hours per week. Transfer Policy International Students who would like to transfer to another school must attend at least one academic term at CSI prior to transfer approval. In order for Transfer Process to be completed, the student has to be in good financial standing with CSI. I understand that I am responsible for the registration and payment of tuition for the course(s) prior to the deadline that is listed in the Academic Calendar. Payment received after the due date is subject to a late charge of $25.00. The College reserves the right to withhold all services to students with outstanding accounts. Student Name Signature: Date:

Ciprian Ionut Zub _____________________________________

Admissions Rep. Signature: Date:

__________________________________ __________________________________ __________________________________

Ciprian Ionut Zub _____________________________________


Ciprian Ionut Zub (Apr 17, 2013)

Apr 17, 2013 ____________________________________

School Official signature is required for all students.

For Office Use Only


The student has been approved for enrollment. ___________________________________________________________________________________________________________ Signature of School Official Date Comments ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________

Signature:

Ciprian Ionut Zub


Ciprian Ionut Zub (Apr 17, 2013)

Email: zub.ciprian@yahoo.com

Document Integrity Verified

EchoSign Transaction Number: TCYGV62M2S5P4P

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