Canada English School

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 CES? Please note that all of our trips are not always available. Make trip inquiries in the question box below or by email.

Banff & Calgary Vancouver & Victoria 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

Have you been abroad before? yes no

Where?/How long?

Describe your personality:

What are your interests and hobbies?

Do you like pets?	yes	no
Do you like small children?	yes	no
Do you smoke?	yes	no
Do you like outdoor activities?	yes	no
Do you play a musical instrument?	yes	no

Which instrument(s) do you play?

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.