Concordia University of Edmonton

Intensive English Summer Program 2018

June 25-July 27

Registration will not be processed if payment is declined.

Applicant

Student First Name *required
Student Last Name *required
Address *required
City *required
Province/State *required
Country *required
Postal Code *required
Gender Male Female *required
Date of Birth
*required
Note: In order to register, you need to be 16 years or older.

Phone (home) *required Invalid phone number
Phone (Cell) Invalid phone number
Email *required Invalid email address

HOW DID YOU HEAR ABOUT THIS PROGRAM?

Through my University (please specify) *required
Through my agent (please specify) *required
Other
*required

Emergency Contacts

First Name *required
Last Name *required
Relationship *required
Mailing Address *required
City *required
Province/State *required
Country *required
Postal Code *required
Phone *required Invalid phone number
Email *required Invalid email address

Do you require any special assistance or have any special needs/consideration we should be aware of? Please specify.

Please indicate your English language level:

HOUSING

Concordia University of Edmonton's on-campus residences are available for students who are 18 years of age and older who would like to rent a room and be provided with a meal plan.
Minor students (under 18) are encouraged to utilize the services of the Canada Homestay Network.
Yes, I will be 18 years of age at the start of the program and I would like a room and meal plan
No, I will arrange my own accommodations

ACTIVITIES

Travel within Edmonton & Cultural Activities with Rocky Mountains Weekend Excursion (optional): $350.00

Details of the payment

  • Instruction Cost (mandatory): CAD$ 2,800.00
  • International Student Medical Insurance Program (mandatory): CAD$ 65.00
  • On-campus Accommodations & Meals (optional): CAD$3,150.00
  • Travel within Edmonton & Cultural Activities with Rocky Mountains Weekend Excursion (optional): CAD$350.00

Refund Policy

  • All costs related to the program, with the exception of the International Student Medical Insurance Program and a $100 administration fee, are refundable if the request to withdraw is received prior to May 31, 2018. No requests for refunds will be permitted after this date.
  • In the event the program is cancelled by Concordia University of Edmonton, a full refund of all monies paid to Concordia University of Edmonton will be made to the participant.
  • Concordia University of Edmonton is not responsible for refunding any costs incurred by the participant for travel, visa, etc. due to cancellation for any reason.

Declaration

  • I have read and understood all the instructions and information accompanying this application form.
  • I have read and will comply with Concordia University of Edmonton's code of student conduct as outlined in Section 8.7.2 of the Academic Calendar.
  • All statements made on this application are true and complete.
  • I understand that misrepresentation, falsification of documents, or withholding requested information are serious offenses which will result in the cancellation of my admission and registration at Concordia University of Edmonton English Summer Program.

Yes, I agree with the information above.
     *required


* Some required fields are missing