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:
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.
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