Lac Des Roches

(imagine birdsong)

 

 

Downtown party

 

 

 

Hoodoo hike

 

Registration & Homestay Application*

(Please use English - Don't worry, it doesn't have to be perfect)

 

My name:
Please call me by this name
My email address: (e.g.: you@aol.com)

My phone number (with country, city, area codes):

Mailing Address:
  

Name:
Address:
 
  Country:
 

 

 My date of birth is: (mm/dd/yy)

 

I am: (choose one)   single   married               Sex:   female   male

 

My age is:             My nationality:    

     

I speak these languages:   

 

In case of an emergency please contact:   (Name & phone - English speaker prefered)

 

I would like to start on (mm/dd/yy)   and study for  weeks

 

My English level is:   Beginner   Intermediate   Advanced

 

Other Relevant Information: (medical needs, allergies,travel plans, etc.)


Are you interested in taking a field trip with Canada English School?   Please note that our trips are not always available. Make trip inquiries in the question box below or by email.

Banff & Calgary   Vancouver & Victoria   USA Shopping   Wells Gray Park

 

What other areas of study are you interested in addition to Practical English, our ESL program?
 (check one or more boxes)
        TOEFL Preparation     TOEIC Preparation     ESL Teacher Preparation

 

Have you been abroad before?   yes   no

Where?/How long?  

 

Describe your personality:

What are your interests and hobbies?

Is there anything that you particularly dislike? (food, activities, situations, etc.)

If you have any questions, please ask them here.

* There is a $150 fee to reserve your homestay. It is to be paid when you send back our copy of the Student Enrollment Agreement. Do not send money now.


     

   English Home Page    Japanese Home Page