Personal Information
 

 Sex

Male                    Female

 First Name*

 Last Name*

 Nationality*

 Birthday*

 (dd/mm/yyyy)

 Home Address*

 Telephone No.*

 Fax No.

 E-mail*

 Ageny

 Address in Canada
   (if applicable)

 Status in Canada

 Vistor    Student   Working Holiday Landed immigrant  

 
 Course Selection
 

 Study Date From*

  (dd/mm/yyyy)

 Study Date To*

  (dd/mm/yyyy)

 Courses*

 IntensiveESL    Semi-intensive ESL  Part-time ESL
 TEYC ( 1 Month Diploma )
 TESOL ( 1 Month Diploma )
 BESINESS ENGLISH ( 1 Month Certificate , 2 Months Diploma )
  INTERSHIP ( Co-op Program )
 FITT Diploma ( Co-op Program )
 PPSP ( Preparation for Public School )
 PEPS ( Powerful English Public School )
 Cambridge (FCE)
 Cambridge (CAE)
 Cambridge (CPE)
 EAP ( English Academic Preparation )

 Speical Listening Course*

 10:35 ~ 12:00       13:00 ~ 14:25    
 14:35 ~ 16:00       16:10 ~ 17:25         

 Speical Writing Course*

 13:00 ~ 14:25

 Advanced      Intermediate     Beginner

 Yes     No
  Score       (ex: TOEFL 100/400)
  Test date (dd/mm/yyyy)

All information given in this application is true and correct. I accept UCL's terms and conditions and the student policies of enrolment. I have read and understood the refund policy.