VIC Registration Form | Vancouver International College

esl vancouver

esl vancouver

NEW EXTENTION

Your Personal Details

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

Choose Your Program

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

Current Level of English : Elementary Intermediate Upper Intermediate Advanced

Homestay Request

Would you like homestay accommodation? Yes No Duration: weeks months

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

My preferences (please select)	Pets No pets
	Children No children
	Other host students No other host students
Do you smoke?	yes no
Are you vegetarian?	yes no

Allergies, medications or health concerns:

Anything else we should know:

Please arrange airport pick-up for me Date of Arrival Time of Arrival (Pacific Standard Time)

Airline Flight Number

esl vancouver