Online Application Form

Apply now. It’s easy. IIE Hawaii will contact you within 1 business day.

Student Information

First Name:
Middle Name:
Last Name:
Date of Birth:	Year --- 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 --- Month January February March April May June July August September October November December Date --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Country of Birth:
Country of Citizenship:
Gender:	Male    Female

• Current Address & Contact Information

Street:
City:
State/Province:
Postal Code:
Country:
Phone:
E-mail:

• Address in Hawaii (if known)

Street:
City:
Postal Code:
Phone:

• Emergency Contact

Name:
Phone:
Relationship:

VISA Information

Type of Visa:

For F1 Visa, please read this Choose Visa Waiver (No Visa Needed) F1 Student Visa B1/B2 Visitor Visa US Citizen Permanent Resident I don't know. Please help me.

If other, please explain:

PROGRAM Information

Start Date:	*Start on any Monday | School Calendar Year --- 2010 2011 2012 2013 --- Month January February March April May June July August September October November December Date --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
End Date:	*End dates are Fridays Year --- 2010 2011 2012 2013 Month --- January February March April May June July August September October November December Date --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

English Program:

Choose --- General English (STEP-16 Hours) General English (IEP-20 Hours) General English (SIEP-28 Hours) Academic Track TOEFL 20 Hours TOEFL 16 Hours Long Stay Program General English + Hula General English + Surfing Conversation - English Cafe Conversation - Business Cafe Conversation - 50+ Cafe Kids & Teens English Private - General English Private - Business Private - Cambridge/TOEIC

Other Information

Have you studied at IIE before? Yes    No

How did you hear about IIE? Choose --- IIE's Website Friend / Family Aloha Street (Website) Aloha Street (Magazine) Kyocharo Newspaper Other Magazine/Newspaper Phone Book Travel / Education Agent Other

If other, please explain:

Are you transferring from another school? Yes    No

If yes, which school?

Will you be needing housing? Yes    No

If yes, please select the types of housing you are interested in: Condo / Apartment        Homestay Shared Student House    Student Residence (Hana)

• Airport Transportation

If you need transportation to or from the airport, please select: No Transportation Needed --- Arrival & departure (Round trip) Arrival only (one way)

• Flight Arrival

Airline:
Flight Number:
Date of Arrival:	Year --- 2010 2011 2012 2013 Month --- January February March April May June July August September October November December Date --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time of Arrival:	Hour --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 : Minute --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

• Flight Departure

Airline:
Flight Number:
Date of Departure:	Year --- 2010 2011 2012 2013 Month --- January February March April May June July August September October November December Date --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time of Departure:	Hour --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 : Minute --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

Confirmation

I have read and agree to IIE’s Cancellation & Refund Policies.       
Yes     <--- You must agree to IIE's Cancellation & Rufund Policies in order to continue. 
No

When IIE receives your Application, IIE will send a confirmation and further instructions within 1 business day.