Online Application Forms

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 general info   personal info   homestay info   academic info   payment info

* I have read and understood the information page containing the          following:
      - Application instructions
      - Program Fees
      - Payment of Fees
      - Refund Policy
      - Travel Arrangements
      - Checklist for Application to the Vernon SD22
      - Academic Information

General Information

All fields identified by a * must be completed

Student’s Family Name :*  
Student’s Given Name :*  
Student’s English Name (if any) :  
Gender :* Male   Female
Date of Birth (day/month/year) :*   / /
Father’s Family Name :*  
Father’s Given Name :*  
Father’s Occupation :  
Father’s Date of Birth (day/month/year) :*   / /
Mother’s Family Name :  
Mother’s Given Name :  
Mother’s Occupation :  
Mother’s Date of Birth (day/month/year) :*   / /
Father’s Email :  
Mother’s Email :  
Home Address Line 1 :*  
Home Address Line 2 :  
City :*  
Province/State :  
Country :*                        
Postal Code :  
Home Tel :*  
Home Fax :  
Father’s Work Tel :  
Father’s Work Fax :  
Mother’s Work Tel :  
Mother’s Work Fax :  
Email :*
check this if more than one person in a family applying and prefer to use the same email address		  
Login ID :* (6-30 characters)  
Password :* (6-20 characters, must contain at least one letter and one number)  
Password again to confirm :*  
You can use the combination of the login ID and password above to log back in to update your contact info or complete this application if you can not complete all five sections at one time
Emergency Contact Person (other than parents)
Family Name :  
First Name :  
Address Line 1 :  
Address Line 2 :  
Phone :  
Fax :  
Email :  
Agent Information
Do you have an Agent? Yes, I have an Agent
No Agent
If Yes, Agency Name :  
          Agency Email Address :  
I authorize this agency to have access to my student information. Yes
No
Education Goals
I am currently in grade :*  
and I wish to apply for grade :*  
I will be in School for :* One semester One year
Longer than one year
Summer Program
I wish to :* Graduate in British Columbia
Develop English skills only
When I have completed this program I intend to :* Apply to a Canadian/U.S. college or
      university
Apply to a university or college in my
      home country
I will not be applying to university or
      college
Other  
I want the following study program :
Summer Session :
Summer, Full Credit (Begins fourth week in June)
Summer, ESL and Activities (July 4-Aug 12, can start any week)
    For summer ESL and Activities program, I want to begin from :
   
    For summer ESL and Activities program, I want to attend for this number
    of weeks :
   
Do you want to continue after the summer program? Yes No
Winter Session :
I want to study for this time period :
    1 Semester (5 months)
    2 Semesters (10 months)
    Other:

Start Dates:
    I wish to start on one of the program's intake dates :
   
    Other start date (elementary school students only, up to grade 7) :
    / /

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School District #22 International Program Logo
 © School District 22 (Vernon) Int'l 1401-15 Street, Vernon, British Columbia, Canada V1T 8S8
Phone: 250-549-9295 Fax: 250-549-9270

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