Vancouver International College- Career Campus

Student Application Form

NEW EXTENSION ADD

PERSONAL INFORMATION

Family Name: Jakovljev Given Name: Vuk

Male Female Date of Birth: M 08 D 14 Y 1996
Mailing Address Street: Ribnjak Gornji put 009 F City: Novi Sad
Province: Serbia Country: Serbia Postal Code: 21000
Permanent Phone #: +381605481996 Current Phone #:

E-mail Address: jakovljev996@gmail.com Nationality: Serbian

Current Visa Type or Status in Canada? Student Visitor Working Holiday Other

How did you hear about VIC? Agency Platform Klaster Art Internet Friends

Education Fair Newspaper/Magazine Other

Career Program

Program Duration Start Date Please indicate the official English

(mm/dd/yyyy) proficiency test score here and send us a
Example TESOL 4 weeks 02/07/2017 copy of the test result:

Program 1 ACSP 14 months 08/08/2023

Program 2 Test Type: ________ Score: __________
Program 3 Test Date (mm/dd/yyyy):______________
Program 4
Test Type: ________ Score: _________
Test Date(mm/dd/yyyy):_______________
HOMESTAY APPLICATION
Do you need a homestay? Yes No Duration: (weeks/months)
Check-in date: M D Y Check-out date: M D Y
I prefer (please check)
Pets No Pets No Preference Are you vegetarian? Yes No
Children No Children No Preference Do you smoke? Yes No
Other host students No other host students No Preference
Allergies / Special medications / Health problems / etc:
Additional Comments or Information:

Do you need airport pick up service? One way Two ways No Arrival Date:
Airline: Flight Number: Arrival Time:

I declare that the information I have provided is true and correct. I’ve read and understand all of VIC’s policies on admissions, dispute
resolu''on, dismissal, refunds, English only policy, and vaca'
'on.
As such, I acknowledge that I will be held subject to the terms, conditions, and policies contained herein.

Signature of Student: Month 05 Day 05 Year 2023

TEL: 604-893-8423 / FAX: 604-893-8428 / E-mail: info@viccc.ca/ 541 Seymour St, Vancouver, BC V6B 3H6 Last Updated: 04.21.2021

www.viccc.ca
www.vancouver.college