Information Request Form
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Would you like more information about Canada House, our programs, or course fees? Please complete the form below, and we will respond as soon as possible!
Title:
Family Name: (required)
First Name: (required)
E-mail: (required)
Street Address:
Apt #:
City or Town:
Province or State:
Country:
Postal or Zip:
Company Name:(if company or agency inquiry)
FAX #:
Telephone #:
Occupation:
What is your currentEnglish language level?
Beginner
Intermediate
Advanced
Which course(s) are you interested in? (check all that apply)
Intensive ESL Program
Part-Time ESL (alone)
English for Business Management
TOEIC
Part-Time ESL (with other courses)
TOEFL
Executive English
Academic Preparation
Information requested:
Summer Language Camp
brochure
course fees
homestay
course calendar
volunteer programs
residence
Other: (please explain)
evening programs
When do you plan to cometo Canada?
How did you first hear aboutCanada House?
Internet
friend
How long do you plan tostudy English?
advertisement
agency
other
Why do you want to study English?
If an agency, which one?
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