ESTEBAN ALEXANDER RAMIREZ MONGUI

03 21 1992 ✔

CARRERA 79 #19A-86 APT 202 El Remanso

Bogotá, Cundinamarca, 110932
Colombia
(+57) 3208971196
[email protected]

Colombia Colombia
Country of citizenship:Colombia Country of residence:Colombia

Mateus Mongui Andrew Stuart

Carrera 79 # 19A-86 Apt 202 El Remanso Bogotá Colombia
3057713599 [email protected] brother

✔ Palisades Park

✔
24 Weeks
✔
05 16 2022

✔ ✔

Last
Lastupdate,
Update,Feb/2022
Feb/2022
 W: www.zoni.edu
E: [email protected]

PART III - VISA REQUIREMENT DATA

(Complete only if you are requesting an I-20 form from Zoni)
You must have a passport valid for at least 6 months.
ssion to the USA: please indicate the purpose of I-20 form.
✔ Initial Attendance Change of Status Transfer Reinstatement Other

MAIL SERVICE REQUEST

Yes, I would like my I-20 form to be sent to my home address. I understand that a mailing fee must be paid before my
documents can be sent.
✔ No, please hold my I-20 form, which will be claimed by my relative, representative or by me.

Are you including your children and spouse as dependents for admission to the USA (F-2 status holders)? Yes ✔ No
If yes, please complete Part IV- Dependents information sheet; otherwise, skip to Part V and student signature.

SPONSOR INFORMATION (not required for self-sponsored students)

Last name: First name:
Address: City, State: Country:
Telephone: Email:
Relationship to the student:

PART IV – DEPENDENT VISA REQUIREMENT DATA

(Complete only if you are requesting an I-20 form from Zoni)
DEPENDENT 1
Name:
(First Name) (Middle Name) (Family/Last Name)

English or Preferred Name: Date of Birth: / / Male Female

(MM/DD/YYYY)
Address:
City, State: Country: Telephone:
Relationship to the student:

DEPENDENT 2
Name:
(First Name) (Middle Name) (Family/Last Name)

English or Preferred Name: Date of Birth: / / Male Female

(MM/DD/YYYY)
Address:
City, State: Country: Telephone:
Relationship to the student:

UNITED STATES OF AMERICA

LastUpdate,
Last update, Feb/2022
Jan/2022
 W: www.zoni.edu
E: [email protected]

PART V – REFUND POLICY

b. the equivalent of six weeks of payment at the non-discounted
1.1.AllAlltuition
tuition payments must be paid in full before starting classes. However, at the
payments must be paid in full before starting classes. However, at the student’s request refundable fees can be applied to future
rate for a payment of 12 weeks or more, all actual housing costs
student’s request refundable fees can be applied to future courses/classes. After a
courses/classes. After a student chooses his/her tuition
student chooses his/her tuition payments, s/he cannot revert to the previous number payments, s/he cannot revert to the previous
incurred by the number of all
school, and weeks paid. school fees.
non-refundable
2. If the
of weeksinstitution
paid. cancels the student’s program of study and/or denied admission subsequent to a student’s enrollment, Zoni will refund all
17. If a student who enters the United States on an I-20 form obtained through
monies paid byis the
2. If a student deniedstudent,
admission except for non-refundable
or enrollment by the institution, charges.
the student will receive the school, and subsequently cancels prior to the start of scheduled classes
3. Registration
a full refund of feeall and
monies Housing
paid, exceptFee for
arenon-refundable
non-refundable and non-transferable. or never attends class, the school will retain:
charges.
4.3.Mail and/or courier
Registration fees are refundable
fee is non-refundable only if admissions/enrollment related documents
and non-transferable. were not
a. the equivalent mailed
of four weeksbyof the school.
payment at the non-discounted rate for
5.4.Prorated tuition refunds will be calculated on a weekly
Mail and/or courier fees are refundable only if admissions/enrollment related documents basis. a payment of less than 12 weeks, all actual housing costs incurred by
6. If the
werestudent
not mailed attends classes even for one day of the week, the school will count that
by the school. the day
school,
asand all non-refundable
a whole week for the school fees. of calculating
purpose
tuition
5. If the refunds.
institution cancels the student’s program of study subsequent to a student’s b. the equivalent of six weeks of payment at the non-discounted rate for a
7. Allenrollment,
refunds will be madewill
the institution within
refund45 allcalendar
monies paid days.
by the student. payment of 12 weeks or more, all actual housing costs incurred by the
school, and all non-refundable school fees.
8.6.Refunds
Proratedwill berefunds
tuition made will only beto the person,
calculated company
on a weekly basis.or agency that paid the school. If the student paid for a program through an agency,
18. If student has started classes, the tuition payment will be reimbursed
s/he
7. Ifmust apply attends
the student directlyclasses
to thateven agency
for onefor
daya of
refund.
the week, the school will count that according to the following criteria:
9. Allweek refunds will week
as whole be made for theinpurpose
the form of a check.
of calculating However,
tuition refunds. if school related fees were paid by credit card, then the school will remit refund
a. Tuition payments for four weeks or less: Tuition payment is not
funds
8. Alltorefundsthe original
will be madecreditwithin
card45used for payment.
calendar days. If school related fees were paid by refundable, wire transfer, then the school will remit funds to the bank
not transferable and student is no eligible to make up any
account from which payment originated and wire transfer
9. If a student never attends class (no-show) or cancels the enrollment prior to the class refunds incur a $40 charge. lost class time.
10. If a student would like the school to remit refund funds to a person other than the b. student, he/sheformust
Tuition payments moreprovide
than four aweeks:
letter authorizing Zoni
Languagescheduled Centers to make
day of class or thecheck
date ofpayable to the
cancellation, personis assigned
whichever earlier. by the student. A valid proof of identification must be presented by assignee
I.
when
10. If claiming
a student check.attends This class,isthe only applicable
refund due will beto tuition
calculatedpayments
using themade by cash
last date of or check.classes, the school will retain the amount equivalent to four weeks
11. If a student never attends class (no-show) or cancels the enrollment prior to the class of start date
payment at the
the student will receive
non-discounted rate and a full
will refund of all
refund remaining
monies datepaid,of determination.
except for non-refundable charges. balance to student.
11. IfIf aa student
12. student provides
who enters advanced thenotice
United of withdrawal
States onsuch that the
an I-20 45-day
form windowthrough
obtained ends the school,
II. and subsequently cancels prior to the start of
scheduled classes or never attends class (no-show), fails to enter, withdraws before starting class,
but before or orat transfers
the midpoint to of
another institution
their payment, Zonibefore
will retain a
days from the last date of attendance (LDA). prorated tuition amount at the non-discounted rate and will refund
starting their program, the school will retain:
12. Zoni representative has the task to submit any refund request from the student to Zoni remaining balance to student.
a. theAccounting.
equivalent of four weeks of payment at the non-discounted rate for a payment of less than 12 weeks, all actual housing costs incurred by
Written notification is not required. III. If a student withdraws after the midpoint of their payment, he/she
the school, and all non-refundable school fees.
13. Refunds will be made only to the person, company or agency that paid the school. will not be eligible for any tuition
b. theIf theequivalent
student paid of sixfor weeks
a program of through
payment an at the non-discounted
agency, rate for
s/he must apply directly to a payment of 12 weeks or more, all actual housing costs incurred by the
that 19. In the event that no notice of withdrawal (written or verbal) is provided,
school, agency andforalla non-refundable
refund. school fees. the school will automatically administratively withdraw the student after
13.
14. IfAllstudent
refunds has started
will be made in classes,
the formthe of atuition
check. payment
However, ifwill be related
school reimbursed according
fees were to has
s/he the following
been absent criteria:
for a maximum of 30 consecutive calendar days
a. Tuition
paid bypayments
credit card,for thenfour
theweeks or less:
school will remit Tuition
refund fundspayment
to the is not refundable,
original credit card not (excluding
transferable any and student
scheduled is noofeligible
breaks the school) to make up any alost
and complete class
refund
time.used for payment. If school related fees were paid by wire transfer, then the school will calculation, processing any refunds to or on behalf of the student.
remit funds
b. Tuition to the bank
payments account
for more fromfour
than which payment originated.
weeks: 20.
i.15.
If aAstudent
student who applies for
withdraws a change
within of status
the first four and
weeks startsafter
classes while classes,
starting waiting for the
the schoolor will
extended
retain their enrollment
the amount at the institution
equivalent to fourbut whose
weeks of last date ofat
payment
Department of Homeland Security’s approval on their petition maytoqualify for a tuition attendance occurs before or at the midpoint of any subsequent period of
the non-discounted rate and will refund remaining balance student.
refund in accordance to number 20.
ii. If a student withdraws after the first four weeks of attending classes he/she will not be period.
for that eligible for any tuition refund. The school will retain all
16. If a student would like the school to remit refund funds to a person other than the
tuition charges.
student, he/she must provide a letter authorizing Zoni Language Centers to make 21. For students whose last date of attendance occurs after the midpoint of
14. No refunds will be made if the school terminates student’s program due to any violation of Zoni’s attendance policies, disciplinary rules, or
federal,muststate or localbylaws.
be presented assignee when claiming check. This is only applicable to tuition of the tuition for that period. Any tuition paid for the balance of the program
15.Refund
payments requests
made bymeetingcash or check.any of the above criteria must be made in writing by sending an email
will be refunded in full.to [email protected] and completing a
Refund a. Request
the equivalent Form (https://www.zoni.edu/refund-policy/)Student
of four weeks of payment at the non-discounted rate for a can also complete the Refund Request Form in school and submit it to the
payment
School Manager. of less than 12 weeks, all actual housing costs incurred by the school, and all non-
refundable school fees.

I was explained the terms and conditions of this agreement and my signature indicates
that I agree to these terms and conditions. I also acknowledge that I have read,
understood and received a copy of the agreement and the student handbook.

de acuerdo con estos términos y condiciones. También reconozco que he leído, J’ai reçu les explications des termes et conditions de cet accord et ma signature
comprendido y recibido una copia del acuerdo y del manual de estudiante. indique que je suis d’accord avec ces termes et conditions. Je reconnais aussi
que j’ ai lu, compris et reçu une copie de l’accord et le guide de l’étudiant.
私は規約と条件について説明を受け、私の署名はその規約と条件に合意した
ことを証明します。
Me foi explicado os termos e condicoes deste acordo e minha assinatura esta de acordo
com o mesmo. Eu tambem reconheco que tenho lido, compreendido e recebido uma copia また、私はその内容を読解し、その合意書のコピーと生徒手帳（学生便覧）
do acordo e do manual do aluno. を授与したことを承認します。

(Student Handbook) (Enrollment .

Agreement) .

sono d’accordo con questi termini e condizioni. Riconosco anche che ho letto, compreso
e ricevuto una copia del contratto (Enrollment Agreement) e del manuale dello student
(Student Handbook).

/ /
(Signature of student or representative of the student) (MM/DD/YYYY)

UNITED STATES OF AMERICA

LastUpdate,
Last update, Feb/2022
Jan/2022