Please fill in all fields listed below and hit SUBMIT. An Omnicom representative will contact you shortly regarding your registration. Thank you!
PERSONAL INFORMATION
First Name*:
Last Name*:
Sex*: Please Select: Male Female
Date of Birth*: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Nationality*:
Street Address*:
City / Town*:
Province / State*:
Postal Code*:
Country*:
Telephone*:
Fax:
E-Mail*:
How did you hear about Omnicom? Agency Advertisement Internet Other
PROGRAM APPLYING FOR
Language Level: Beginner Low Intermediate Upper Intermediate Advanced
Comments/Special Requests: TOTAL TUITION FEES + Registration Fee ($120):
$
I require Homestay ($150 fee applies) Yes No
Homestay - (Private Room & 2 meals) - $190/week Minimum 4 weeks accommodation
weeks
*Each additional day - CD$28
days
Homestay - (Private Room & 3 meals) -- $200/week Minimum 4 weeks accommodation
*Each additional day - CD$30
*Homestay for 18 & under (per 4 weeks) - additional "Residence Accommodation (Only Toronto) please contact us for more details
CD$50
Airport Pick up/Drop off: None Pick up at the airport ($100) Drop off at the airport ($50) Pick up AND Drop off ($150)
Material Fee for Intensive English Programs
CD$45~60
Material Fee for Specialized Programs
CD$35~100
TOTAL ACCOMMODATION FEE: $ *Please note that Tuition fees are calculated separately above.
DURATION OF STUDY
Full-Time (30-hour program)
Full-Time (25-hour program)
Part-Time (15-hour program)
Other:
I would like to start Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec and study for weeks in Toronto Calgary
HOMESTAY/Residence accommodation
I would like Homestay or Residence Accommodation ***
I would like homestay/residence starting:
From: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
To: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Do you smoke?
Yes No
Pet preference?
Dogs Cats No Pets It does not matter
Do you have any allergies?
Yes No If yes:
How many meals?
2 Meals 3 Meals
Placement preference:
Family with children
Family with teenagers
Without children
No Preference
Please indicate any special dietary needs or medical concerns:
Would you like airport pickup? Yes No Airline:
Arrival Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Arrival Time: Flight #:
*Required Fields **Please review the additional fees & accommodation rates listed above that are NOT included in calculated rate.
***Please contact us if you would like Residence Accommodation or if you are traveling with more than one person - discounted Homestay rates are available.
For current promotions, please contact your agent.
Total TUITION + ACCOMMODATION: $