Apply

Membership Application

Apply For Membership

Please complete this e-mail form to become a member at the International Center and we will contact you to schedule a free orientation appointment (form must be completed in English).

NOTE: All fields in red are required for submission. NOTE: The International Center does NOT provide Visas and you must be in the US or coming to the US to apply.
CONTACT INFORMATION
Prefix:



Apt:






PERSONAL INFORMATION
Date Of Birth:	19
Country of Birth:
Gender:	Male Female
Marital Status:	Married Single
Arrival Date in the US:

WORK
Are you working in the United States?
If yes, what is your occupation?

EDUCATION
What level of education have you completed?
Name of school in home country:
Are you a student in the United States?
If yes, what school do you attend?

OTHER

How did you hear about the International Center? Please select one.

Please give the name and phone number of an emergency contact:

Name:

Relationship:

Phone#:

PLEASE READ THE AGREEMENT BELOW BEFORE SUBMITTING:

The International Center in New York membership offers a variety of programs and services, but does not guarantee participation in all of them. Membership fees are not refundable and you can not give your card to anyone for any reason, including if you leave New York City or the United States before your membership card expires. All Center members must follow the rules and policies of the International Center as they are listed on the "Center Policies" board.

Do you understand the above agreement and do you promise to abide by it?

Yes

*To study English at the Interational Center you must be 18 years or older.