FIU - ELI - TOEFL Registration Form

Last Name (Primary Family Name) *
Second Last Name (If Applicable)
First Name *
Middle Name
Panther ID Number
Profile Picture *

Attach Files
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
E-Mail *
Mobile Telephone (Ex.: 305-321-4567) *

Please include your country and city code if this is not a U.S. number.
Date of Birth Date of Birth * / MM / DD YYYY
Country of Birth *
Current Status (Optional)
Term *
Schedule Selection

• Fridays from 2:30 P.M. to 5:30 P.M.
• Saturdays from 9:00 A.M. to 12:00 P.M. *

Schedule Selection

• Fridays from 2:30 P.M. to 5:30 P.M.
• Saturdays from 9:00 A.M. to 12:00 P.M. Fridays Saturdays
Which modality would you prefer?

Which modality would you prefer? In-Person Remote (Online) Hybrid (Both In-Person & Remote) Whatever is available.
Are you flexible with your schedule selection?

Are you flexible with your schedule selection? Yes No
Comments:
Paragraph
I understand that after the first day of class I cannot request a change in schedule. I understand that the first day of class is the last day for me to request a refund of 80% of my tuition. Payment of tuition also included a $50 registration and testing fee, which is not refundable. ELI is not responsible for collecting nor refunding any fees paid to the University Bookstore and/or the Parking and Traffic Department. All tuition refunds must be requested in writing and given to the person in charge of registration. ELI is not responsible for any parking tickets or citations issued to students. ALL vehicles parking on-campus are required to have a valid parking permit. I affirm that the information provided on this application is accurate and true and I have read and understood the payment and refund policies.
Acceptance of Terms *

Acceptance of Terms Yes, I accept the terms listed above.
Draw your signature into the box below.

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Date Date * / MM / DD YYYY