Family Name*
    Gender* MaleFemaleOther

    Given Name*
    Date of Birth*
    Home Address*
    Postal Code*
    Student E-mail Address*
    First Language*
    Emergency contact in your home country*
    Self-assessed language level* AdvancedElementaryIntermediateIntroductoryUpper-intermediate
    Status in Canada* VisitorWorking HolidayStudentOther(Please Specify)
    Please specify

    Programs with Co-op* Business Foundations 100 (Certificate) (12+12 weeks)Business Foundations 200 (Certificate) (24+24 weeks)Business Foundations 400 (Diploma) (48+48 weeks)Hospitality Management 6 Month (Certificate) (12+12 weeks)Hospitality Management 1 Year (Diploma) (24+24 weeks)Hospitality Management 2 Year (Diploma) (48+48 weeks)Business Communications 100 (Certificate) (12+12 weeks)Global Client Care 150 (Certificate) (18+18 weeks)
    Programs 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)
    Pathway Option ESL(GE20) Pathway
    Program Start Date*
    End Date*

    Program Schedule* Daytime (9AM start)Evening (4PM or 5PM start)
    Payment Plan (1 or 2 years program only) Yes ($100 administrative fee, optional)

    Employment Services Talent Incubator Service ($500, optional)Employment Foundation Service ($400, 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
    Please specify

    Do you want SELC to arrange Medical Insurance? YesNo
    Medical Insurance Start Date
    Medical Insurance End Date

    Do you want SELC to arrange accommodation (homestay) for you? YesNo
    Check-in Date
    Check-out Date
    Private Single RoomShared Room (with travelling companion only)
    Full Board (3 meals)Half Board (Breakfast & Dinner)
    Custodianship Letter (if required) YesNo

    Only for student under 18 years

    Do you smoke? YesNo

    If yes, you must agree to smoke outside

    Are you OK living with pets? YesNo
    Please specify
    Are you OK living with children? YesNo
    Please specify
    Do you have any allergies? YesNo
    Please specify
    Special requests or needs
    Airport Pick-Up Service YesNo
    Arrival Date
    Airline & Flight No.
    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)

    Agency Details (if applicable)

    You MUST read the Conditions of Enrollment. I confirm that the information I have provided is true and that I have read, understood and agree to abide by the SELC Conditions of Enrollment.

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