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MALASPINA SUMMER! 2004

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MALASPINA SUMMER!  2004

SCHOLARSHIP APPLICATION FORM

  

(for students 18 years or older)


   

·          You must enclose:  A 250 word essay:  If you were Prime Minister of Canada, what would you do to increase the awareness in Brazil of Canadian Arts, Culture and Education?

·          1 passport sized photo

 

PERSONAL DATA: (please print)

Family name                                                      First Name                                                             Middle Name

Mailing address:

E-mail:

Telephone:

Fax number:

Date of birth: (day, month, year)

Sex:     Male           Female       

Country of birth:

Citizenship:

First Language:

Passport/travel document number:

Country of issue:

Parents' address if different from above:

Telephone number:

Fax Number:

E-mail address:

In your own words, please describe your ESL background (for example, how many years have you studied English?; do you have a TOEFL, IELTS or TOEIC score?):

Are you………‚  Beginner level ?               ‚   Intermediate Level?                ‚   Advanced level?  (check one)

TIMEFRAME: (Students must register for a minimum of 2 weeks.)

Date I wish to BEGIN my study (check one)

Date I wish to COMPLETE my study (check one)

r       June 14    

r       June 28

r       June 25    

r       July 9

r       July 12

r       July 26

r       July 23

r       August 6

r       August 9

r       August 20

APPLICATION DEADLINE:  5 WEEKS PRIOR TO SELECTED START DATE

Check the program of your choice:

Morning program (3 hours):                                                            Afternoon program (2 hours):

r       Academic English

r       Academic

r       Conversation English

r       Activity

Optional Trips:

r       Vancouver

r       Long Beach

r       Victoria

PLEASE READ THE FOLLOWING BEFORE SIGNING:

1.     I/we certify that all statements on this application are true and complete.  I/we understand that misrepresentation of this information in any way may result in cancellation of admission or registration status.

2.     I/we understand that once a student commences a Summer program, tuition and other fees will not be refunded if a student decides to leave the program for reasons other than medically documented illness.


Date:                                                                                                   

Parent's Signature:                                                                          

                        (required for students under the age of 19 years)



Student's Signature:________________________________



 
 

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