APPLICATION FORM

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Student Information
First Name
Last Name
Gender
Date of Birth mm dd yy
Nationality
Address
City
State/Province
Zip/Postal Code
Country
Telephone #
Fax #
E- mail

Course Registration
Which course are you applying for?
Start Date mm dd yy
How many weeks?
Registration Fee C$ 100

Home Placement  
Do you want Homestay?
For how long?
Homestay Placement C$ 100
Do you have any allergies or health problems?
Do you smoke?
Do you like pets?
Do you want airport pick-up?
Any comments?
Refund Policy