Enrollment Form

Family Name*
Given Name*
Home Address*

Gender*
Date of Birth*
Postal Code*

City*

Province*

Country*

Student E-mail Address*
Nationality* ---ArgentinaAustraliaBelgiumBrazilCanadaChileChinaColombiaCzech RepublicDenmarkEgyptFinlandFranceGermanyGreeceIndiaIndonesiaIrelandIsraelItalyJamaicaJapanLithuaniaLuxembourgMalaysiaMaltaMexicoMongoliaNepalNetherlandsNew ZealandNorwayParaguayPeruPhilippinesPolandPortugalRomaniaRussiaSaudi ArabiaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwedenSwitzerland - German-speakingSwitzerland - French speakingSwitzerland - ItalianTaiwanThailandTurkeyUnited Arab EmiratesUnited KingdomUSAUruguayOther

Phone*
First Language*

Emergency contact in your home country*
Self-assessed language level* AdvancedElementaryIntermediateIntroductoryUpper-intermediate

Status in Canada* VisitorWorking HolidayStudentOther(Please Specify)

Study Selection with Co-op* Business Foundations 100 (Certificate) (12+12 weeks)Business Foundations 200 (Certificate) (24+24 weeks)Business Communications 100 - Co-op (Certificate) (12+12 weeks)Hospitality Management 6 Month - Co-op (Certificate) (12+12 weeks)Hospitality Management 1 Year - Co-op (Certificate) (24+24 weeks)Hospital Management 2 Year - Co-op (Diploma) (48+48 weeks)

Study Selection without Co-op* Food & Beverage Management (Certificate) (12 weeks)Introduction to Communication 101 (Certificate) (6 weeks)Business Communications 110 - No Co-op (Certificate) (12 weeks)
Daytime or Evening Study* Daytime (9AM start)Evening (4PM or 5PM start)

Program Start Date*

End Date*

Weeks*

Employment Foundation Service Basic (included)Premium ($750, optional)

Note: Please contact SELC about our Pathway Partnerships and Employment Foundation Service. Due the short duration of these programs, students must arrive with all appropriate permits valid for the entire length of their program (i.e. valid study and co-op work permits).

How did you hear about SELC? WebsiteBrochureFriend/FamilyAgencyOther

Do you want SELC to arrange Medical Insurance? YesNo

Do you want SELC to arrange accommodation (homestay) for you? YesNo

Airport Pick-Up Service YesNo

Note: SELC must be notified of changes in arrival details 72hours in advance in order to guarantee pick-up. If delayed in transit, please contact our emergency representative as stated on your homestay confirmation letter (the Airport pick-up service fee is non-refundable if instructions are not followed)