T.I.E.L.C. LLC  Study in Canada Program

Po Box. 76044. Atlanta, Ga  USA  30358   Fax: 1 (678) 868-2192   Email: tielc@intertesol.us             

ADMISSION APPLICATION

FIRST NAME   (AS IN PASSPORT)

 

LAST NAME   (AS IN PASSPORT)

 

DATE OF BIRTH

 

  MALE

  FEMALE

 

COUNTRY OF BIRTH

 

CITIZENSHIP

 

PASSPORT NO.

 

EXPIRATION  DATE

 

ADDRESS

 

CITY

 

COUNTRY

 

POSTAL CODE

 

TELEPHONE

 

FAX

 

EMAIL

 

 SCHOOL ATTENDED

FROM    TO

 

CERTIFICATE EARNED (IF ANY)

 

PARENT/GUARDIAN CONTACT INFORMATION

 

RELATIONSHIP

 

PARENT/GUARDIAN IN CANADA

 

ACCOMMODATION RESERVATION REQUEST

   PRIVATE ROOM                                                 

  SHARED ROOM

  SHARED APARTMENT

  HOMESTAY WITH MEALS

  HOMESTAY WITHOUT MEALS

  WILL ARRANGE MYSELF

 

ACADEMIC INFORMATION

  1 Term (3/4 moths)

  2 Terms (6 months)

  3 Terms (9/12 months)

 

ENROLLMENT TERM

  JANUARY 

  APRIL

  SEPTEMBER

 

PAYMENT

 

CURRENCY