Test and Interview
Step By Step Towards Summer Program
Academic/Trip Calendar
Summer Plus Program
Summer Schedule
Summer Calendar
Summer Plus Application
Name: _______________________________________________________
r
Male
r
Female
Address:
__________________________________________________________________________
City:
___________________
State:
____________ Country:
_______________ ZIP: ____________
Telephone:
( ______ )
____________________ Work: ( ______ ) ________________________
Fax:
( _______ ) _______________________ E-Mail:
_____________________________________
Language(s) you speak:
r
Arabic
r
English
r
Persian
r
Urdu
r
Others: _________
Birth Place: __________
Birth Date: ___________ Social Security Number: _____ - _____ - _________
Educational Status:
r
High School
r
Diploma
r
BA
r
MA
r
Ph.D.
Current Status:
r
Full-time Student r
Full-time Worker
r
Part-time Student
r
Part-time Worker
r
Other ______________________
I would like to apply for:
r
Full Package (Umra, Study in Iran, Tour in Iran: $3125)
r
Study in Iran Only: $1450
r Umra Only: $1850
Limited
Scholarship for Summer Plus Program is available.
Please enclose the following:
·
A $25 non-refundable application
fee ($40 Late Application fee)
·
An official transcript of
student’s high school/college or an authorized photocopy of his/her most recent degree
·
Two recommendations
Date _______________ Student’s
Signature _____________________________
Application(s) should be sent to: IINY (Imam Mahdi Seminary)
55-11 Queens Blvd., Woodside, NY 11377 USA
Or Fax To: 1-718-565-0589
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