Title:		Choose One Mr. Mrs. Ms.   X
First Name:		X
Last Name:		X
Birth Date:		X (Turn off pop-up blocker) or type date mmddyyyy
Nationality:		X
Address:
City:
State/Province:
Postal Code:
Country:		X
Emergency Contact:
Phone Number:		X
Cell Number:
E-mail Address:		X
Occupation:
Languages Spoken:		X
Do you have any medical conditions?
Do you have any allergies?
Are you a smoker?		Choose One Yes No
Check-in  Date:		X (Turn off pop-up blocker) or type date mmddyyyy
Check-out Date:		X (Turn off pop-up blocker) or type date mmddyyyy
Do you require Airport Pick-up?		Choose One Yes No
Arrival Date:		(Turn off pop-up blocker)
Arrival Time:		(hh:mm:) PM or AM
Airline:
Flight Number:
Arriving From:
School Name:
Period of Study:		Choose One Full-time Part-Time Exam Preparation
Your English Level is:		Choose One Beginner Elementary Intermediate Advanced
School Start Date:		X (Turn off pop-up blocker) or type date mmddyyyy
School End Date:		X (Turn off pop-up blocker) or type date mmddyyyy

*PLEASE NOTE: In order to check in one of our student house bedrooms you have to be a student, proof of enrolment is required before your arrival. The majority of our student houses are within 30 - 45 minutes of travel time to Downtown Vancouver

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