Online Application Forms

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 general info   personal info   homestay info   academic info   payment info

* I have read and understood the information page containing the          following:
      - Application instructions
      - Program Fees
      - Payment of Fees
      - Refund Policy

General Information

All fields identified by a * must be completed

Student’s Family Name :*  
Student’s Given Name :*  
Student’s English Name (if any) :  
Gender :* Male   Female
Date of Birth (day/month/year) :*   / /

Father’s Family Name :  
Father’s Given Name :  
Father’s Date of Birth (day/month/year) :   / /
Father’s Occupation :  
Mother’s Family Name :  
Mother’s Given Name :  
Mother’s Date of Birth (day/month/year) :   / /
Mother’s Occupation :  

Home Address Line 1 :*  
Home Address Line 2 :  
City :*  
Province/State :  
Country :*  
Postal Code :  
Home Tel :*  
Home Fax :  
Father’s Work Tel :  
Father’s Work Fax :  
Mother’s Work Tel :  
Mother’s Work Fax :  
Email :*
check this if more than one person in a family applying and prefer to use the same email address
 
Additional Email:  
         This is: parent's email    student's email
Login ID:* (6-30 characters)  
Password :* (6-20 characters, must contain at least one letter and one number)  
Password again to confirm :*  
You can use the combination of the login ID and password above to log back in to update your contact info or complete this application if you can not complete all five sections at one time

Emergency Contact Person (other than parents)
Family Name :  
First Name :  
Address Line 1 :  
Address Line 2 :  
Phone :  
Fax :  
Email :  

Education Goals
I am currently in grade :*  
and I wish to apply for grade :*  
I will be in School for :* One semester One year
Longer than one year
I wish to :* Graduate in British Columbia
Develop English skills only
When I have completed this program I intend to :* Apply to a Canadian/U.S. college or
      university
Apply to a university or college in my
      home country
I will not be applying to university or
      college
Other  
I want to begin my studies in :* Semester 1: September – January
Semester 2: February – June
Preferred start date (day/month/year) :*   / /

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© Gulf Islands International Program
112 Rainbow Road, Salt Spring Island, BC Canada V8K 2K3 Tel: 250.537.9944 Fax: 250.537.9512

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