#450-1050 Alberni St.

Vancouver
BC, CANADA, V6E 1A3
ph: 1.604.688.9366 fx: 1.604.648.9105
email: ​study@canada-english.com

2020 Application Form

1.0 Personal Information

First Name AYMEN ISMAIL

_________________________________ Last Name AHMED
_________________________________

Gender √❏ Male Birthday 16-AUG-1984

_______________________​ (dd/mm/yyyy)
❏ Female
Address Addis Ababa Piassa Arada sub City Keye Birth Country
_________________________________ ETHIOPIA
_________________________________

Bahir Site Condominium Bul .3 Flr.3 Apartment 01 Citizenship

_________________________________ ETHIOPIAN
_________________________________

Phone +251923571824
_________________________________ Email aymenalkhulidi@gmail.com
_________________________________

2.0 Course Selection

ENGL 110 - ENGL 145 (Smrt English ESL, Exam

Preparation, University Pathway, Business English) Start Date 28/SEP/2020
_______________________​ (dd/mm/yyyy)
❏ Part Time (18 Lessons per week) From 26 To 32 of a Weeks
√
❏ Full Time (28 Lessons per week)
# of Weeks _________________________________

❏ Full Time Intensive (38 Lessons per week) Private ____________________________ hours
❏ Premium Intensive (28 Lessons + 5 hours of Lessons
Private Lessons per week)
❏ EAP 140 / 145 (16 weeks)

3.0 Accommodation

Student Residence
√
❏ Single Room, Shared Kitchen # of Weeks From 08 To 12 of a Weeks
_________________________________
❏ Shared Room, Shared Kitchen
Arrival 21-SEP-2020
_______________________​ (dd/mm/yyyy)
❏ Studio Apartment (Sleeps Two)
Departure 21-MAR-2021
_______________________​ (dd/mm/yyyy)
Homestay
Allergies, NON
_________________________________
❏ Single Room/Shared Bath
Diets,
(2 meals/day, 3 meals/weekend) NON
_________________________________
Medical?
❏ Single Room/Private Bath
(2 meals/day, 3 meals/weekend)

4.0 Other

Airport Medical Insurance Meal Card at eh! Restaurant

❏ Require Pickup √
❏ I would like medical insurance ❏ $25 ($30 value)
√
❏ Require Pickup & Drop-off for the duration of my studies ❏ $50 ($60 value)
❏ $100 ($125 value)
√
❏ $200 ($250 value)
 #450-1050 Alberni St. Vancouver
BC, CANADA, V6E 1A3
ph: 1.604.688.9366 fx: 1.604.648.9105
email: ​study@canada-english.com

5.0 Method of Payment

All payments may be made by bank transfer, VISA, or money order.

6.0 Refund Policy

Tuition
The Refund policy is dictated by PTIB and is as follows:
1. If the institution receives tuition from the student, or a person on behalf of the student, the institution will
refund the student, or the person who paid on behalf of the student, the tuition that was paid in relation to
the program in which the student is enrolled if:
a. the institution receives a notice of withdrawal from the student no later than seven days after the
effective contract date and before the contract start date;
b. the student, or the student’s parent or legal guardian, signs the student enrolment contract seven
days or less before the contract start date and the institution receives a notice of withdrawal from
the student between the date the student, or the student’s parent or legal guardian, signed the
student enrolment contract and the contract start date; or
2. The institution will refund the tuition for the program and all related fees paid by the student or a person on
behalf of the student enrolled in the program if the student is enrolled in the program without having met the
admission requirements and did not misrepresent his or her knowledge or skills when applying for
admission.
3. If a student does not attend any of the first 30% of the hours of instruction to be provided during the
contract term, the institution may retain up to 50% of the tuition paid under the student enrolment contract
unless the program is provided solely through distance education.
4. If the institution receives a notice of withdrawal from a student:
a. more than seven days after the effective contract date and
i. at least 30 days before the contract start date, the institution may retain up to 10% of the
tuition due under the student enrolment contract, to a maximum of $1,000.
ii. less than 30 days before the contract start date, the institution may retain up to 20% of the
tuition due under the student enrolment contract, to a maximum of $1,300.
b. after the contract start date
i. but before 11% of the hours of instruction to be provided during the contract term have
been provided, the institution may retain up to 30% of the tuition due under the student
enrolment contract.
ii. and after 10% but before 30% of the hours of instruction to be provided during the contract
term have been provided, the institution may retain up to 50% of the tuition due under the
student enrolment contract.
5. If the institution provides a notice of dismissal to a student and the date the institution delivers the notice to
the student is:
a. before 11% of the hours of instruction to be provided during the contract term have been provided,
the institution may retain up to 30% of the tuition due under the student enrolment contract.
b. after 10% but before 30% of the hours of instruction to be provided during the contract term have
been provided, the institution may retain up to 50% of the tuition due under the student enrolment
contract.
6. The institution will refund fees charged for course materials paid for but not received if the student provides
a notice of withdrawal to the institution or the institution provides a notice of dismissal to the student.
7. Refunds required under this policy will be paid to the student, or a person who paid the tuition or fees on
behalf of the student, within 30 days:
 #450-1050 Alberni St. Vancouver
BC, CANADA, V6E 1A3
ph: 1.604.688.9366 fx: 1.604.648.9105
email: ​study@canada-english.com

a. of the date the institution receives a student’s notice of withdrawal,

b. of the date the institution provides a notice of dismissal to the student,
c. of the date that the registrar provides notice to the institution that the institution is not complying
with section 1(c) or 2 of this policy, or
d. after the first 30% of the hours of instruction if section 3 of this policy applies.
8. If an international student delivers a copy of a refusal of a study permit to the institution, sections 1, 4, and
6 of this policy apply as if the copy of the refusal were a notice of withdrawal, unless the international
student requests an additional letter of acceptance for the same program that was the subject of the refusal
of a study permit.

Residence
1. If a student cancels their booking before arrival, CCEL will keep 1 month of the residence fees and refund
the remainder. If a student cancels their residence after arrival we require 1 month notice and the
remainder will be refunded. If a student’s visa is rejected they will get a full refund of residence fees.

Homestay
1. Any request for a refund of unused homestay fees must be made within six months of leaving the program.
Any refunds not claimed during that period will be forfeited to CCEL. To get a full homestay refund, we
require four week notice before the new period starts for cancellations. When notice is given in less than
four and with at least two weeks advance, 50% is refunded; when less than 2 weeks is given, there is no
refund. Homestay placement fee is valid for one year and it is not refundable and all refunds are subject to
an administration fee.
2. Once the form has been completed and signed, allow 30 business days to receive your refund.
3. Refunds will be made in the same method payment has been received.
4. Proper cancellation notice of four weeks must be given and refund will be calculated accordingly.
5. All homestay refunds are subject to a CAD $150 administrative fee.

7.0 Refund Procedure

Students must submit a completed “Application for refund” form to the College office.

√❏I certify that I have read, understood, and agree to the refund policy.
❏ I certify the information provided by me on this form is true and accurate and that I am 19 years of age or older.

A Y M E N I S M A I L A H M E D Date
Printed Name _______________________________ 25-AUG-2020
_____________________​ (dd/mm/yyyy)

Signature _______________________________ Parent's Signature _______________________________

(under 19 years old applicants only)