Your Information

    YOUR Name (required)
    LAST / FAMILY Name (required)
    Date of Birth (dd/mm/yy) (required)
    Gender:
    COUNTRY of Origin/Birth
    PASSPORT Number (required)
    HOME ADDRESS (required)
    PHONE (incl. country & area codes)
    Your EMAIL (required)

    Emergency Contact Person

    CONTACT FULL NAME (required)
    CONTACT PHONE Number (required) (incl. country & area codes)
    RELATION TO YOU
    CONTACT E-MAIL (required)

    English Program

    SCHOOL NAME

    Homestay Information

    START DATE (mm/yy)
    END DATE (mm/yy)
    Do you have special dietary requirements?
    If yes, please indicate below. (For example, are you a vegetarian?)
    Do you have any allergies? Do you take any medications. If yes, please indicate them:
    Please list your Hobbies/Interests:
    Can you live with pets?
    Do you smoke?
    Can you live with young children?

    Airport Transfers

    ARRIVAL DATE AND TIME
    FLIGHT #
    Do you need airport pickup?

    Other Information

    Enrolment conditions and refund policy
    I have read and agree to be bound by the Terms & Conditions and the Payment and Refund Policy (select the checkbox if you agree)
    My payment deposit will be made at least four weeks prior to the school start date (select the checkbox if you agree)
    Please enter the following code: captcha

    This 'code' is to validate that you are a person & not an Internet spambot.

    We are having some technical difficulties receiving applications from certain countries.
    Please take a screenshot of your application and email it to vch@telus.net

    Your application will be reviewed and processed once received.
    At this point we will send you an invoice with our simple payment procedures.