ACADEMICS - Application Form

Name*

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Home Address*

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Telephone/Cell*

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E-mail*

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Nationality*

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Passport Number*

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Expiry Date*

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Profession*

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Academic Background

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Current university attended (if applicable)

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Have you Studied Arabic before?*

Yes

No

If Yes, where and for how long ?

A. Type of program I would like to apply for:*

Intensive Total Immersion Program: 20 hrs/week of language study and cultural activities*

Non-Intensive Program: 6 to 12 hrs/week of language only

*Please refer to website for more details about the cultural activities included in the intensive total immersion program.

B. Length of program I would like to apply for:*

Short Term : 7 wks (140 hrs)

Long Term : 13/14 wks (280 hrs)

Please tick next to terms desired. Tick terms I and II if you wish to enroll in the full 14-wk semester.*

Fall Semester: mid Sept

Spring Semester: mid Feb

Summer Semester: mid Jun

C. My elective courses*

Select One Elective Course: (All intensive program students are entitled to one elective course for free. Non intensive program students, or intensive program desiring more than one elective course, can take elective course(s) at additional fee) :*

How did you hear about HIAS *

If others please specify