Enrollment Application
1. Family Name
2. Given Name
3. Home Address
4. E-mail Address
5. Home Phone Number
6. Postal Code
7. Occupation
8. Gender
Male
Female
9. Birthday(month/day/year)
10. Nationality
11. Native Language
12. Passport Number
13. Passport Expiration Date(month/day/year)
14. Type of visa
Tourist
Student(F-1)
Other
15. Highest Level of Education
Select List:
16. Have you previously completed an English Language course?
Yes
No

      16.1. When?(month/day/year)
  

      16.2. Where?
  

       16.3. Course Length?
       

       16.4. Level Completed?
       Select List:
17. What is your current English Level?
Select List:
18. Do you require airport pick-up?
Yes
No
19. Do you want Homestay? (If Yes, please fill out the Homestay form also).
Yes
No
20. Requested course starting date(month/day/year)
21. Requested course ending date(month/day/year)

22. If you plan on attending our school for less than 6 months you may enter Canada on a tourist visa. If you plan on staying longer than 6 months you need a student visa. Do you need a student visa? (if Yes, we will email/fax you the instructions to get a student visa.

23. I have read and agree to follow the GEOS Canada Refund Policy  

  Yes