Canada Campus Visits Application

We will be in contact parents/legal guardians of individuals below 21 at a later stage to collect medical and travel information.

APPLICATION FORM

First Name(required)

Last Name(required)

Mobile Number (with country code)(required)

Country

Postal Code

State/Province (If applicable)

Citizenship Expiration (If you have no citizenship, type N/A)(required)

Email Address(required)

Highest achieved level of education(required)

City:

Country of Residence

Residence Address (mailing)

Emergency Contact Name(required)

Emergency Contact Relationship (Father, Mother, Legal Guardian, etc)(required)

Emergency Contact Home Phone (Include Area Code)(required)

Emergency Contact Mobile Phone (Include Area Code)(required)

Emergency Contact Work Phone (Include Area Code)(required)

Emergency Contact Email Address(required)

Checking this box confirms you have carefully read, fully understand, and agree to abide by our Guidelines and Safety Concerns.(required)