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Registration Form

To reserve a linguistic program, please fill out this form below. We'll get in touch with you within 12 to 24 hours.

We wish to remind you that we do not

Before filling out this form,
please read the following
very carefully. Click here

give working stages at the end of the course
offer student exchange
help in obtaining student loans
offer translation services
give visas. For visas please go to the local consulate for the country your wish to visit. Be advised that this process can be very long and does not guarantee that you will be allowed to travel to the country you want to go.

Thank you for your understanding

I confirm I read and approved the general enrolment conditions.

After clicking "SEND" below, we'll show you a confirmation sheet you'll be able to print and fax to our office.
On this confirmation sheet, you'll be able to write your credit card number and all information required for the payment.
A copy will be send by E-Mail to the address shown below. Please be sure you'll have access to this E-Mail address.
It's up to you to choose this copy as your confirmation to be faxed to our office.

Fields in Red are required

Applicant's name

Name

First name

Date of birth

Sex:

Man
Woman

Mother tong

Nationality

Address

City

State

Postal code

Country

Phone

Fax

Email

Person to contact in case of emergency

Name
Address
Phone

Accommodation

For family accommodation, please choose the following options:

Young children ?	Yes
	No
	No preference

Pets ?	Yes
	No
	No preference

Do you smoke ?	Yes
Do you smoke ?	No

Do you accept smokers ?	Yes
Do you accept smokers ?	No
Number or meals per day

If necessary, please indicate any details (likes, dislikes, allergies, special requests) that allow us to better choose your hosts

N.B. Hosts taking students are not always "families" and are not required to include their guests in their social and family life. However, this type of accommodation give the both parties the possibility to exchange for a more complete immersion

Starting date

Ending date

Lengh of stay

Number of lessons per week

Programme number
(if applicable)

For your programme

You consider yourself to be:	Beginner
	Elementary
	Intermediate
	Advanced
	Excellent

Level of education:	Secondary
	College
	University

Your present occupation
Your preferred sports and hobbies
Please indicate any special requests you may wish (arrival greetings, extension arrangements, transportation, hotels, hosts....) Voyages Université cannot guarantee you'll obtain all your requests but assures you of its full cooperation
Airport transfer:	Yes
Airport transfer:	No
Arrival airport
Airline
Flight number
Local time of arrival
Date of arrival

Important information for your family accommodation

If you don't wish the offered transfer, please indicate the approximate time and date of arrival in the family:

N.B. Programs for professionals, executives and commercials: Please send us a letter explaining your expectations. This letter will be sent to the school.

Destination City wished for

Travel Agency

If you are a travel agency, please enter you Name / Agency / Address / Tel / Fax / Email below. Thank you.

Message

Credit Card Deposit Required

Name on Card:
Credit Card:
Credit Card Number:
Expiration:	/

Payment Secured: read attached notes

Signature

I authorise Voyages Université to debit my credit card above for the 300 $CAN or 600$ CAN depending of the condition. (see general conditions) .

Conditions

I confirm having read and approved the general inscriptions conditions.

Code

Verification

Capture the 4 letters in the image above before you click Send Registration Form.

Code :

Tel: +1 (514) 922-9564 Fax: +1 (514) 500-7154 Email: