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2009-2010 International Student Application Form

***Returning students, apply here!***

* Mandatory Fields

PROGRAM OPTIONS
Choose one *



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ELEMENTARY/SECONDARY





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SHORT TERM




Number of Weeks

Start Date
Student applying to enter which Grade? *
Mandatory Field

STUDENT INFORMATION
First Name *
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Last Name *
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Street Number & Name , PO Box, Apt# *
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City *
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Province/State
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Country *
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Postal Code
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Telephone *
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Fax
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Student E-mail
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Gender *
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Student's Date of Birth:   Day *
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Month *
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Year *
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Languages Spoken *
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Passport Number
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Issuing Country
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Issue Date
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Expiry Date
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PARENT/GUARDIAN
Father's Full Name (first and last) *
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Father's Telephone
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Fathe's Date of Birth:   Day *
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Month *
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Year *
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Father's English Level
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Mother Full Name (first and last) *
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Mother's Telephone
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Mother's Date of Birth:   Day *
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Month *
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Year *
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Mother's English Level
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Parents' Email *
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HOMESTAY REQUIRED
Is a Host Family Needed? *
Mandatory Field
If a homestay is required, please complete the application form.
If no homestay required, please provide the following:
Name, Address, Phone and Relationship

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MEDICAL INFORMATION
Insurance mandatory and included in the program
Medical conditions/allergies:
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STUDENT INFORMATION
Name and Address of Present School *
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Present Grade *
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Comments/Special Requests
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Choose at least 4 subjects *
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Specify
What are your goals? *
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What career would you like pursue? *
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Preferred location or School if known
We will make every attempt to place the students in preferred locations however there are no guarantees.
First Choice
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Second Choice
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Current English Skills *
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Has student ever written English assessment? *
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Name and Score
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Agent/Educational Consultant's Email
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** All International students will be given an English Language Assessment prior to program start date to ensure appropriate placement

REQUIRED DOCUMENTS

Note: This application will NOT be processed until the following documents are received.

  • An English letter from the current school to confirm the student\'s grade placement and to describe the student\'s conduct in the school.
  • An English school transcript from the most current and previous school year.
  • The completed Upper Canada Leger Centre Participation Agreement signed by both the student and by the parent(s) or legal guardian.
  • Immunization record (vaccines).
  • Payment of deposit/tuition fee.
  • Copy of the student passport
  • A minimum of $250 CND non-refundable deposit required with application

PAYMENTS

International Wire Transfer
For wire payment information, please contact us directly at international@uclc.ca

Visa or Mastercard
Please fax information to 1-613-930-7251

  • Card Number
  • Expiry date
  • Cardholder’s Name
  • Amount to charge*
    * Note: 3% charge applies

Prior to arrival we would like background information about the student’s family, interests, hobbies, food preferences and picture alone and with family, if possible. We will send the info regarding host family.


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