Vancouver International College

esl vancouver

esl vancouver

NEW EXTENTION

Personal Information

Family Name :		Given Names :
Male Female		Date of Birth M D Y (ex : 2005)
Mailing Address	Street, City :
Province, Country :			Postal Code :
Telephone No :		Fax No :
E-mail Address :		Nationality :
Current Visa Type (If applicable): Student Visitor Working Holiday Other(Specify)
How did you hear about VIC? Agency Internet Friends Eduction Fair Newspaper/Magazine Other

Program

Starting Date : M D Y (ex : 2005) Duration: weeks

Current Level of English : Elementary Intermediate Upper Intermediate Advanced

Homestay Application

Do you need a homeStay? Yes No Duration: weeks months

Check-in date M D Y Check-out date M D Y

I prefer (please check)	Pets No pets
	Children No children
	Other host students No other host students
Do you smoke?	yes no
Are you vegetarian?	yes no

Allergies/Special medications / Health problems/etc:

Additional Comments or Information :

I will need airport pick-up Date of Arrival Time of Arrival (Pacific Standard Time)

Airline Flight Number

esl vancouver