Enrollment Form

Family Name*

Gender* MaleFemaleOther

Given Name*

Date of Birth*

Home Address*

Postal Code*

City*

Province*

Country*

Student E-mail Address*

Phone*

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

First Language*

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

Status in Canada* VisitorWorking HolidayStudentOther(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*

Weeks*

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

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)