Application Form

On-Line Application Form - English Language Study Only

NOTE: Applicants interested in English and the undergraduate program must fill out the undergraduate application. Here is a link to the on-line application: Undergraduate Application

English-Only Application Procedure

Complete the on-line application form (below).
Complete the Certificate of Financial Responsibility (click here to download: Certificate of Financial Responsibility) and either fax, email, or mail with a bank statement or copy of your scholarship award/financial guarantee document.
Fax, email, or mail proof that you have completed at least two years high school or university-level English language classes (send copies of transcripts, tests, or a written statement).*

* You may be asked to give a writing sample to further determine academic readiness.

Fax: 503-768-7320

Email: aes@lclark.edu

Mail: 0615 SW Palatine Hill Road, MSC 125, Portland, OR 97219 USA.

Term you will enter:
How long do you plan to study with us?
Family Name:
Given Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Postal Code:
Country:
Telephone:
Email Address:
Alternate Email Address:
City and Country of Birth:
Country of Citizenship:
Country of Residence:
Gender:	Female Male
Marital Status:	Single Married
If married, will your spouse be with you?	Yes No
Birth Month:
Birth Day:
Birth Year:
How many years of English coursework have you had in high school or university?
What is your level of English?
Do you have a visa?	Yes No US Citizen/Green Card
If yes, what type of visa to you have?
If other, please specify:
If you are a transfer student, which institutition issued your I-20?
Housing Preference:	On Campus Off Campus
Comments: