Foreign Student Visa Application

(Please PRINT this form and fill it out, then FAX it to: + 1-305-259-9535) If you have any questions on

how to fill this form, please call Dean International at +1-305-259-5611, or email us: info@flymiami.com

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Name of Applicant: Print Name: Last: ___________________ First: ____________________ Middle:_______________ Telephone (please include country code) :______________________ Present Address: Street: _____________________________________ City: _________________ State/Province: ______________ Postal Code/Zip: __________ Country:____________
Emergency Contact: Print Name: Last: ___________________ First: ____________________ Middle:_______________ Emergency Telephone (please include country code) :______________________ Emergency Address: Street: _____________________________________ City: __________________ State/Province: ______________ Postal Code/Zip: __________ Country:____________
PERSONAL INFORMATION: Gender: ___MALE / ___FEMALE Height: ______ (CM / INCH) Weight: _____ (KILO / LBS.) Birth date: _____/_____/_____ Place of Birth (Country): ______________________ MONTH DAY YEAR Marital Status: ___SINGLE / ___MARRIED Current Occupation: ________________________ Country of Citizenship: _________________ Passport Number: _________________________ Drivers License Number (if Applicable): _________________ Country: _______________
Drug/Alcohol conviction within the past 12 months? _____Yes ____No
SCHOOL RECORDS: List three most recent schools attended (High School, University, and Technical) SCHOOL LOCATION DATES ATTENDED DIPLOMA/DEGREE
		From___/___ To ___/___
		From___/___ To ___/___
		From___/___ To ___/___
Select Start Date: _____ / ____ / ____ Month Day Year	Student housing required? ___ YES / ___ NO Do you smoke? ___ YES / ___ NO

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FLIGHT EXPERIENCE: (if Applicable) List all flight certificates/ratings held (If Any): Name of School where ratings were obtained: F.A.A Medical: ____None ____1^st Class ____2^nd Class ____3^rd Class Date of Issue______
Flight Time Solo	Total Time	Cross-Country		Night	Complex		Instrument	Simulator
Dual
FLIGHT COURSE REQUIRED (Check only those you will attend)
___ PROFESSIONAL PILOT PROGRAM (No previous experience required. This course combines the private, commercial, instrument and multiengine courses marked with an asterisk (*)			___*PRIVATE ___*COMMERCIAL ___*INSTRUMENT ___*MULTI-ENGINE			___ CFI ___ CFI II ___ CFI-ME ___ ATP
APPLICATION AGGREEMENT Please fill out this form. Attach a photocopy of your valid passport. Attach a bank statement demonstrating that you or your sponsor have the financial resources required for your education in the U.S. (Funds shown should reflect flight course tuition). Upon receipt of the above by fax, an I-20 form and acceptance letter will be sent to you (applicant), you will then be able to proceed to a U.S. Consulate or Embassy in your country to request a visa. Upon arrival to Dean International, students are enrolled according to the requirements of the school and the U.S. Government. Also upon arrival, a deposit equal to 50% of the estimated tuition cost is required prior to starting the Program. The remaining balance of 50% must be paid at the midpoint of the course, as determined by Dean International. Signature Approval of Applicant: I apply for admission to the courses indicated, and accept the above terms and conditions. Student Signature ____________________ Date: _____ / ____ / ____ Month Day Year Parents/Guardian/Sponsors Where students are under the authority of parents, guardians, etc., the responsible authority must sign here: I accept the above terms and conditions: Parent/Guardian/Sponsor Signature ____________________ Date: _____ / ____ / ____ Month Day Year Relationship to Student:__________________ Relationship Telephone (please include country code) : _________________________ Relationship Address: Street: __________________________________________ City: _________________ State/Province: ______________ Postal Code/Zip: __________ Country: ___________