Online Application for Admission Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastDate of Birth *Phone Number *Email Address *Country of Birth *Country of Citizenship *Overseas Address *Local U.S. AddressEmergency Contact Name *FirstLastRelationship To You *Emergency Contact Phone Number *Emergency Contact Email *Status You Will Be Attending As *-select one-International Student (F-1)U.S. ResidentOtherIf Other Please SpecifyProgram *-select one-Intensive (Whole Day)Semi-Intensive (Half Day)Number of Weeks *Select the number of weeks you will be attending4 Weeks8 Weeks12 Weeks24 Weeks36 Weeks48 WeeksSelect Year *Select the year you wish to begin studying20192020Select Month *Select the month you wish to begin studyingJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovmeberDecemberCourses *ESLTOEFLTOEICTutoringConversationBusiness EnglishPlease check all that applyAirport PickupDo you require airport pickup?YesNoFlight InformationIf yes, please provide your flight detailsHousing PlacementDo you require housing placement assistance?YesNoDuration of stayHousing ChecklistI would like mealsI do not require mealsI am ok with petsI am ok with childrenPlease check all that apply if you require housing placementCredit Card NumberIn order to process your Application for Admission you will need to pay your $150 non-refundable application fee.Name On CardExpiration DateSecurity CodeCard Type-select one-VisaMastercardAmerican ExpressAuthorizationYes I understandBy clicking the box you understand and authorize that Rosemead College will charge you a $150 application fee with the credit card information you've provided.PhoneSUBMIT MY APPLICATION