استمارة التسجيل

VIC’s online application is temporally unavailable, sorry for the inconvenience.
To register, please download the registration form. [VIC Registration Form](PDF, 920KB)
Send any questions or your completed registration form to [email protected] or directly to your advisor.

Personal Information
NEW EXTENTION
Family Name* :					Given Names* :
Gender* : Male Female					Date of Birth* (ex : 2014)
Home Address		Street, City* :
Province* :				Country* :			Postal Code* :
Telephone No*:					Fax No :
E-mail Address* :					Nationality* :
Current Visa Type (If applicable)*:		Student			Visitor		Immigrant
Current Visa Type (If applicable)*:		Working Holiday			Other(Specify)
How did you hear about VIC?*		Agency			Internet		Friends
How did you hear about VIC?*		Education Fair			Newspaper/Magazine		Other
Program
Full-time (25hrs/wk)			Semi Full-Time (20hrs/wk)			AM Part-Time (15hrs/wk)
PM Part-Time 2 (10hrs/wk)			PM Part-time 1 (5hrs/wk)
Starting Date* :					Duration* weeks
Current Level of English* :	Beginner		Lower Intermediate		Intermediate	Upper Intermediate		Advanced
Homestay Application
I will need a homestay					Duration: weeks months
Check-in date					Check-out date
I prefer (please check)		Pets No pets No preference
		Children No children No preference
		Other host students No other host students No preference
Do you smoke?		yes no
Are you vegetarian?		yes no
Allergies/Special medications / Health problems/etc :
Additional Comments or Information :
Airport Pick-up
I will need airport pick-up			Pick-up Only Two ways
			Date of Arrival			Time of Arrival :(Pacific Standard Time)
			Airline :			Flight Number :
			Date of Departure			Time of Departure : (Pacific Standard Time)
			Airline :			Flight Number :
* I declare that the information I have provided is true and correct. I've read and understand all of VIC’s policies on admissions, dispute resolution, dismissal, refunds, English only policy, and vacation. As such, I acknowledge that I will be held subject to the terms, conditions, and policies contained herein. VIC Policy Fee & Refund Policy