American Education Center
	ESL Application for Admission

Name	Last-Family   name				上传照片(2寸) 请不要大于200K
	First
Cell phone
Telephone
Date of Birth
Country of Birth
Present Address
Gender		Female      Male
Degree you have got

Date you have taken (or plan to take) TOEFL				Score
Date you have taken (or plan to take) IELTS				Score
Date you have taken (or plan to take) ESL				Score

I certify that above information provided is true correct and complete.
Student's Signature		Date