INTERLINK Language Center at Valparaiso University

Using the form below you can submit your application online. Simply fill in the required information, affirm your understanding of the agreement terms, and click the submit button at the bottom of the page. An INTERLINK representative from Valparaiso University will confirm by e-mail the receipt of your application and give you additional instructions. Please be aware that we cannot process your application without the receipt of the financial items and documents listed below, or without agreement to the terms and conditions in item V. below. Once your application is approved, your Form I-20 will be issued and mailed within 24-48 hours. The Form I-20 is necessary for you to apply for an F-1 (student) visa.

To complete your application, you will need to send us the following items:

  • A copy of your high school or university grades 
  • US $100 non-refundable application fee
  • a copy of your passport
  • An official financial support statement from your bank, sponsor, or guardian certifying that you have at least US $4600 available for your first term at INTERLINK

* Please draw checks on US BANKS ONLY and make check payable to INTERLINK. Fees can also be paid using a credit card. The credit card authorization form will be sent with the email confirming receipt of your application.

Alternatively, you can print out this form and send it with the enclosures listed above to:

INTERLINK LANGUAGE CENTER
1010 Union Street
Valparaiso, Indiana 46383-4527

If you require additional information or have questions, don't hesitate to contact us.

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I. PERSONAL DATA
1. Family Name:
2. First Name:
3. Email Address:
4. Mailing Address (PO Box or Street No.):
5. City / State or Province / Country:
6. Postal Code:
7. Telephone Number:
8. Fax Number:
9. Country of Birth:
10. Country of Citizenship:
11. Date of Birth (MM/DD/YY):
12. Sex:
13. Maritial Status:
14.If married, will your family accompany you?
15.Smoking Preference:
16.Preferred start of INTERLINK studies:
17.Length of study at INTERLINK (weeks):
18. Plans following INTERLINK study completion:
19. Where did you hear about INTERLINK?
20. In case of emergency, contact Name:

Address:

Telephone #:

II. ACADEMIC INFORMATION
21. Highest educational level completed:
22. Your field of study:
23. TOEFL or other English test you've taken:

Score:

Date taken [DD/MM/YY]:

24. Rank your English speaking ability:
25. Rank your understanding of English:
26. Rank your English reading ability:
27. Rank your English writing ability:
28.

If you have attended another English program in the US, please enter the name and address of that program:
29.

Have you been admitted to another institution?

If yes, please provide the institution's name:
III. HOUSING PREFERENCE
. Rank the following housing options
in order of your preference:		 (1 = first choice, 2 = second choice, 3 = third choice)
30. University Residence Hall:
31. Host Family:
32. Apartment: 
IV. HEALTH AND FINANCIAL INFORMATION
33.

Do you have any physical disability or health problems that will require special assistance?

If yes, please explain:
34.

Who will finance your education in the US?

If other, please specify:
35.

Do you wish to receive your admission materials via express mail? 
NOTE: The charge for this service is $50.

V. AGREEMENT TERMS
36.

I understand the terms of my admission and agree to abide by the rules of the Center and of the University. I, and/or my sponsor, will be fully responsible for the cost of my studies while at INTERLINK. Further, I authorize release of my credentials and of my medical records for medical and insurance purposes; I also authorize treatment of any illness or injury by qualified health personnel during my attendance at INTERLINK.
37.Today's Date (MM/DD/YY):

Note: Form I-20 will not be sent without agreement to terms in item V. above.

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