ELS Melbourne - Florida Tech Access Request

Florida Tech is a partner with ELS Language Program, a Berlitz company. During your journey with ELS at Florida Tech, you will immerse in the English language, learning from not only your teachers but also our very own internationally diverse culture. Your experience here will be one to remember.

To begin your program with us and ensure a quality experience we will need you to fill the following information. Providing these details will grant you access to many of our amenities here on campus.

ID Card access to many places on campus
Panther Dining and other dining locations
Clemente Center Gym
Laundry
Library access
And more

Please note you have had to register with ELS program first, for more details please contact Reilly Brand, ELS Melbourne International Student Advisor reilly.brand@ilscedu.com or visit https://www.els.edu/

Registration with ELS is valid for 180 days from your arrival date. You may resubmit this form to extend your access.

First Name*

Middle Name

Last Name*

Birthdate*

Sex*

Email Address*

Confirm Email Address*

Personal Address

Country

Street

City

Region

Postal Code

Copy of Passport*

Please upload a copy of the photo and signature page of your passport.

ID Card Photo*
Click here for more information on your Florida Tech ID Card.

Please upload a photo for your ID card.

Emergency Contact Information

Relationship*

First*

Middle

Last*

Phone*

ELS Guest Attribute

Internal - Touchpoint