American Institute of Diamond Cutting, Inc.

MAILING ADDRESS:

P.O. Box 4067

Deerfield Beach , Florida 33442-4067 USA

Continental US 1-800-831-8470

International (954) 574-0833

APPLICATION FOR ENROLLMENT

DIAMOND MANUFACTURING AND EQUIPMENT PROGRAM.

SECTION A:

Last Name __________________First Name ____________________Middle Name_____________

Street Address________________________________________________________________________

City/Town_______________________________________State/Province_______________________

Country _________________________________________US Zip Code_________________________

Country Code_____________(if available) Telephone______________________________________

Country of Citizenship __________________________Country of birth_______________________

Nationality________________________________________________________ □Male □Female

Applicant's Date of Birth: Month ______________Day ______________Year_________________

SECTION B:

Are you a high school graduate:_________________ Years attended_______________________

Year of graduation ________________Name of High School_______________________________

Country/State________________________________________________________________________

College or institution of higher learning attended (if any):

(1) Name:_______________________________(2) Name:_____________________________________

Address :___________________________________ Address:__________________________________

(1) Years attended:_____________________ (2) Years attended:___________________________

Degrees, diplomas, or certificates received:

(1) a._______________________________________(2) a.______________________________________

(1) b._______________________________________(2) b._____________________________________

(1) c._______________________________________(2) c.______________________________________

List any special training or work experience received in a related field.

(1)___________________________________________________________________________________.

(2)___________________________________________________________________________________.

SECTION C:

Please state your purpose for taking this program. ______________________________________________________________________________________

Are there special emphasis you would like considered during your training?_____________________________________________________________________________.

Do you suffer from any physical disability? □Yes □No

If so, please explain briefly:________________________________________________________________________________

SECTION D:

I have enclosed with this application:

□ 2 Passport size photographs.

□ An enrollment fee of U.S. $500.00 (Inclusive of total tuition)

□ Complete, sign and date this application.

My date of attendance for the diamond manufacturing and equipment program is:

_______________-___________________to____________________-____________________. Day Month Day Month

NOTE: Please call the Institute to arrange a mutually agreed class schedule. Class dates should be arranged as early as possible since other students are also scheduled throughout the year.

SECTION E:

1. All applications will be handled and filed according to the date each application is received. In the event current classes are filled, the Institute reserves the right to set a new enrollment date for the next available class.

2. A student is expected to abide by all rules and regulations as printed in the Institute official school catalog.
3. The remaining portion of tuition must be paid in full before the commencement of classes. All funds must be paid in US dollars in the form of a certified check, money order, cashiers check or wire transfer.

Applicant's Signature_______________________First______________Last___________ (Please Print)

Date__________________