Name

Gender
MaleFemale

Date of Birth

Nationality (i.e.Passport Used)

Contact Phone

Email

Address

Select Your Status in Canada
Canadian CitizenPermanent ResidentStudy PermitVisitor's VisaOther

Program of Interest
---ESL + Hospitality CertificateHospitality Management DiplomaHospitality Management CertificateAccounting DiplomaTravel & Tourism Management DiplomaFlight Attendant DiplomaBusiness & Hospitality Communication DiplomaESL Certificate

When would you like to start the program

Education Background
Name of High School/College/University: Graduation Date: Major of Study: Other Training/Work Experiences/Certificate: Official Test Scores(TOEFL/TWE/IELTS/LPI/): Date of Completion:

For International Student Services
Do you require temporary medical insurance?
YesNo

Do you require any Homestay Arrangement and or Airport Pick Up?
YesNo

Comments
Comments for Medical Insurance: Comments for Homestay/Pick Up:

Emergency Contact Person
Name: Phone Number: Relationship to you:

Supporting Document Copy of Valid Passport

Supporting Document Copy of High School Diploma/Transcript or other English Proficiency

I hereby agree that Create Career College may collect, use and disclose my personal information for the purpose of providing career counseling, educational funding and employment placement services to me, and to verify the accuracy of the information I have provided. Further, I acknowledge that I have read and understand the general information and policies as contained in the Student Handbook posted on Create Career College website. Note: Admissions requirements cannot be waived by the either the College or the student.