Sample form – United States Institute of Language and Clerical Studies

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Getting Started - Step 1 of 11

Before you begin the HESEAP application, these are items you will need:

• A credit card. There is a a $149.99 Committee Review Fee required to submit your application.
• A photo of yourself to upload.
• Your education history, including addresses and dates.
• Information regarding your education level, such as degrees and certifications.
• Employment history including previous employers, dates or possible references.
• Specifics about your volunteer history.
• Any academic awards you may have.

I acknowledge that I have read and fully understand the above. *

I acknowledge that I have read and fully understand the above.

Degree and Minor Selection.

To enable the HESEAP Review Committee to assess your prior education and experience, it is essential to choose the specific degree, minor, and electives you are seeking HESEAP Credit for. Please make selections below.

To obtain the TESOL certificate, you must select either the TESOL Origins and Methods degree or designate TESOL as a minor alongside another degree program.

Minor *

Select Minor

Electives *

ACC1004 Accounting
ACC2004 Accounting II
ACC2008 Cost Accounting
BUS1145 Sales
BUS1221 International Etiquette & Protocols
BUS1337 Management
BUS1343 Marketing
BUS1773 Business Etiquette & Protocols
BUS1991 Human Resources
BUS2145 Sales II
BUS2337 Management II
COU1121 Counseling
COU2121 Counseling II
COU2653 Family Counseling
COU2688 Grief Counseling
COU2778 Youth Counseling
COU3121 Counseling III
ECN1145 Economics
ECN2145 Economics II
EDU1133 Discipline in School
EDU1148 Education
EDU1358 Class Management
EDU1373 Motivating Others
EDU1688 Online Education
EDU1742 TESOL
EDU2133 Discipline in School II
EDU2142 Early Childhood Education
EDU2148 Education II
EDU2256 Secondary School Education
EDU2358 Class Management II
EDU2378 Virtual Classroom Management
EDU2688 Online Education ll
EDU2742 TESOL II
EDU3148 Education III
EDU3742 TESOL III
EDU4148 Education Advanced
ENG1154 Effective Presentations
ENG1175 Expository Writing
ENG2154 Effective Presentations II
HIS1385 Origins of Ancient Civilizations
HUM1166 Ethics
HUM1265 Human Development
HUM1391 Morals
HUM2166 Ethics II
HUM2391 Morals II
HUM3166 Ethics III
LAN1388 Origins of Language
PSY1082 Child Psychology
PSY2082 Child Psychology II
PSY2971 Social Psychology
PSY3082 Child Psychology III
SOC2274 Charitable Services II
SOC2295 Sociology II

Select 6 electives

Personal Information

Title *

Name *

First

Middle

Last

Upload a recent full face photo. *

Click or drag a file to this area to upload.

Passport Type Photo

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone *

Date of birth *

Current Citizenship: *

Languages and Dialects Spoken *

Character & Good Citizenship

Select your Religion: *

Are you registered to vote in your country, and if so, do you vote? *

Please explain your reason for not being registered to vote, or for not voting. *

Are you active military? *

Are you a military veteran? *

Would you serve in your country's military if called on to do so? *

Please explain why you would not serve in the military if so called upon to do so. *

Education

This section requires you to provide details about your previous education

High School Information

Have Your Graduated High School or Have a GED? *

Graduation from high school or a GED is required to enroll in the USILACS Bachelor Degree Program. This ensures that students have the basic academic foundation needed for higher education.

Name of High School or Who Issued Your GED Certificate. *

City, State or Provence, Country *

Example: Los Angles, California, USA

Date of Graduation or GED Award *

College Information

How many colleges have you been enrolled in? *

Name of School/Address *

Example: Harvard University, Massachusetts Hall, Cambridge, MA 02138

Course/Degree Program *

Dates of Attendance *

Name of School/Address *

Example: Harvard University, Massachusetts Hall, Cambridge, MA 02138

Course/Degree Program *

Dates of Attendance *

Trade School Information

How many trade schools have you been enrolled in? *

Name of School/Address *

Program Description *

Dates of Attendance *

Name of School/Address *

Program Description *

Dates of Attendance *

Non-Formal Education Information

Non-Formal Education:
Non-formal education encompasses structured, short-term training programs designed to achieve specific objectives, such as the development of skills, values orientation, and similar targeted outcomes. Examples: Seminars, TESOL, PSS, SKE, etc.

How many forms of Non-Formal Education have you been part of? *

Program Description *

Title of Certificate Obtained *

Dates of Attendance *

Program Description *

Title of Certificate Obtained *

Dates of Attendance *

Program Description *

Title of Certificate Obtained *

Dates of Attendance *

If you have any additional education or trade licenses or certification please attached here.

Click or drag files to this area to upload. You can upload up to 5 files.

Note: Upon request, it may be necessary to provide official documentation, which must be substantiated by appropriate certificates or formal records obtained from the institution through the designated program.

Work Experience (Paid or Volunteer)

Describe your three most recent work experiences "Jobs". Don't forget unpaid or volunteer work. Example: Pioneer, MS, LDC, Red Cross Volunteer, etc.

# 1. Name and Address of Company or Organization *

Position *

Starting date *

Ending Date *

Describe your work, duties, or responsibilities *

# 2. Name and Address of Company or Organization

Position

Starting date

Ending Date

Describe your work, duties, or responsibilities

# 3. Name and Address of Company or Organization

Position

Starting date

Ending date

Describe your work, duties, or responsibilities

If necessary, attach additional documents using the same formate as above

Click or drag a file to this area to upload.

Honors, Awards, and Citations Received

In this section, provide a detailed account of any awards, citations, or appointments you have received from educational institutions, community groups, civic organizations, or religious institutions. Include recognition for work excellence, notable achievements, service contributions, and other distinguished accomplishments.

Do you have any Academic Awards? If so, how many? *

Award Received

Name and Address of Organization providing award

Date

Award Received

Name and Address of Organization providing award

Date

Award Received

Name and Address of Organization providing award

Date

Do you have any volunteer, civic or religious awards/citations, or appointments? *

Award, Citation or Appointments

Name and Address of Organization

Date

Award, Citation or Appointments

Name and Address of Organization

Date

Do you have any work related awards or citations? If so, how many? *

Award Received

Name and Address of Organization providing award

Date

Award Received

Name and Address of Organization providing award

Date

Award Received

Name and Address of Organization providing award

Date

Creative Works and Special Accomplishments

In this section, provide a comprehensive description of your creative works and special accomplishments. Examples include inventions, published or unpublished writings (both fiction and non-fiction), musical compositions, visual or performing arts projects, achievements in sports, as well as social, cultural, and leisure activities. Be sure to highlight your participation in competitions and any prizes or distinctions you have earned. This information will assist in evaluating your proficiency and skill level in these areas.

Description *

Date Accomplished *

Name and Address of Publishing Agencies (if written, published work), or any Associations/Institutions which can attest to the quality of the work.

If necessary upload additional sheets

Click or drag a file to this area to upload.

Lifelong Learning Experience

In this section, outline the diverse life experiences from which you have gained meaningful learning. Be sure to include details about unpaid volunteer work and any other relevant activities that contributed to your personal and professional development.

Hobbies/Leisure Activities *

Leisure activities that include skill ratings for competitions, such as rope climbing or photography, can also reflect your proficiency level, which will facilitate the evaluation process. Additionally, regular engagement with educational broadcasts, such as monthly teaching programs, may be recognized as valuable learning experiences.

Special Skills *

Write down special skills you think will be related to the field of study you want to pursue.

Work-Related Activities *

Certain work-related activities present opportunities to acquire new skills and knowledge. For instance, being assigned to projects outside your regular job responsibilities can lead to significant learning experiences. Please refrain from listing formal training programs already mentioned elsewhere. However, you may include experiences categorized as on-the-job training or apprenticeships.

Volunteer Activities *

Only include volunteer activities that offered significant learning experiences applicable to the course you are pursuing credit for. Examples may encompass involvement in counseling programs, public speaking events, roles in formal or informal teaching, and leadership positions within organizations.

Travels : Cite places visited and purpose of travel *

Provide a detailed description of the nature of travel you have undertaken, specifying whether it was for leisure, employment, volunteer, business, or other purposes. Clearly articulate the new learning experiences gained from these travels and explain how they contributed to your personal growth and development.

Essay

In conclusion, compose an essay detailing how earning your degree will enhance your personal development and positively influence your community, workplace, society, and country.

Paragraph Text *

Conclusion

To be eligible for the HESEAP Fast-Track Program, you must affirm and declare that, over the past four years, you have engaged in educational activities, dedicated time to personal study, actively attended and participated in educational events, and possess at least four years of experience in both teaching and learning. *

I hereby solemnly swear under oath and affirm that I meet the qualifications as described above
No, I do not qualify

I declare under oath that the statements and information provided herein are true and accurate. *

Agree

Statement of Nondiscriminatory Policy as to Students *

I acknowledge that I have read and understand the “Statement of Nondiscriminatory Policy as to Students”

NONDISCRIMINATORY POLICY: The institution offers a globally accessible education, that embraces students irrespective of race, color, or national origin. It is firmly committed to upholding equal rights and opportunities, while maintaining a stringent prohibition against discrimination across all institutional policies and programs.

HESEAP Committee Review Fee *

Price: $149.99

Payment Method *

Stripe
Paypal

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Stripe Credit Card *

Card

Name on Card

Please ONLY press Submit onetime. It you hit Submit more than one time, you will be double charges. Thank you for your understanding!

Name

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