APPLICANT INFORMATION
Title : Mr. Ms.
First Name :
Family Name :
Address :
Postal Code :
Telephone :
Fax :
Email :
Date of Birth : Month : Day : Year :
Language Information
English Level : Beginner Intermediate Advanced
Native Language :
ESL Program
I am applying for the following program: 4 Week Program
8 Week Program
12 Week Program
16 Week Program
Week Program
Youth Summer Program
I am applying for the following program: 4 Week Program
8 Week Program
None
Personal Information
Are you applying for Homestay Accommodation? Yes No
If yes, please specify:  
Are you a smoker ? : Yes No
Are you allergic to pets? : Yes No
Expected Arrival Date : Month : Day : Year :
Expected Departure Date : Month : Day : Year :
Other Information
How did you find out about this program?
Credit Information
Card Type : Visa MasterCard
Name on Card :
Card Number :
Expiry Date : Month : Year :

A non-refundable deposit of $300.00 (Canadian dollars) plus Homestay registration fee (if applicable) will be applied to your Credit Card. Balance of fees will be collected during registration on your first day.

     

Once your application has been received, we will send you a confirmation letter containing information about your arrival, your host family, and other information useful for your stay in Canada. Please keep in mind that you must acquire health and accident insurance for the duration of your stay in Canada. You may arrange for that before you come or within the first five days of arrival in Canada.