Summer High School Prep Program

Transcription

1 Summer High School Prep Program 2015 Application Package Alexander Academy / IH Vancouver # West Hastings Street, Vancouver, British Columbia, V6B 1P1 Canada T: / E: e.elliot@alexanderacademy.ca

2 Summer High School Prep Program Student student information Information First Name Program Information Family Name Registration Date: (dd/mm/yy) Program Start date: (dd/mm/yy) Program Finish Date: (dd/mm/yy) Nationality Native Language Program Options (Please check all that apply ) Date of Birth (dd/mm/yy) Street Address Gender Female Male Week One - July Ecosystems Week Two - July History Week Three - July Technology Week Four - July Forensics Week Five - August Theatre Week Six - August Great Canadians Week Seven - August Ecology City Province/State Fee Information Postal Code Home phone PARENT ONE Contact Name Country Mobile phone Early Bird Registration - Before May 31, 2015 Weekly Fee $ Week Five SPECIAL $ All 7 weeks - receive a 25% discount on tuition Regular Registration - After May 31, 2015 Weekly Fee $ Week Five SPECIAL $ All 7 weeks - receive a 20% discount on tuition PARENT ONE Emergency Contact Phone Number PARENT TWO Contact Name Homestay $ / week - includes 3 three meals Airport Transfer $90.00 each way Custodianship $50.00 PARENT TWO Emergency Contact Phone Number Student s Approximate Level of English: (Check appropriate box) Elementary Lower-Intermediate Upper-Intermediate Advanced Accommodation Information Homestay Not needed Single room Full Board Custodianship Yes No Housing Start: (dd/mm/yy) Medical problems or allergies: Double room Full Board Housing Finish: (dd/mm/yy) Do you require airport transfer? On Arrival: Yes No For Departure: Yes No Arrival date (dd/mm/yy) Arrival time (hh:mm) Airline & Flight No. Payment Information Total Program Cost Accommodation fees note Airport transfer(s) Custodianship Medical insurance = Total Cost Due All payments must be made in Canadian dollars. All payment documents must include: [1] Full name of student, [2] Programstart date Parent(s) Signature(s) Yes, I have read, understand and accept all of the enrolment conditions and refund po licies. Sign full name and date to indicate you have agreed to the terms and conditions. Signature Parent One Date Departure date (dd/mm/yy) Departure time (hh:mm) Airline & Flight No. Medical Insurance Provider Signature Parent Two Date Name Emergency Contact for Insurance Policy # (All students MUST have medical coverage for their full study period - please include copy with your application) Do you require medical insurance? Yes No Agent s Information (Optional) Insurance Start: (dd/mm/yy) Insurance Finish: (dd/mm/yy)

3 Alexander Academy & IH Vancouver Summer High School Prep Program Off-Campus Field Trip Permission Statement of understanding and permission for full participation in Alexander Academy and International House s off-site programs. Full Name of Student: Dates of Program: STATEMENT OF PERMISSION: I have read and understood the details noted on page 2 of this form. I hereby give permission for (print student name here) to participate in all aspects of Alexander Academy and International House s Summer High School Prep Program, scheduled during the normal day, from 9:00am 4:00pm. The Alexander Academy and International House Summer High School Prep Program includes but is not restricted to the following field trips: Lynn Canyon Ecology Centre & Suspension Bridge Police Museum Musqueum Cultural Centre UBC Fly over Canada / Canada Place Museum of Anthropology UBC Arts Club Theatre Van Arts / Vancouver Film School BC Sports Hall of Fame Museum of Vancouver Stanley Park & Ecology Centre I understand that Alexander Academy teachers/leaders/volunteers will accompany the students on all off-campus activities and that they will consider the student s safety to be of primary importance at all times. I understand that transportation arrangements for off campus activities will involve my child travelling by any of the following modes: public transportation including bus, Skytrain, Canada Line, Seabus, or chartered school bus. I agree to hold Alexander Academy and International House, its employees and volunteers harmless from any damage or injury to my child that may occur, however caused. If emergency medical treatment is required, I give permission for the teacher in charge or other leaders to authorize the appropriate medical authority to proceed with treatment in my absence. I DO NOT give permission for my child to participate in the following activity /activities: Signature of Parent / Guardian Date Parent / Guardian printed name

4 2 OFF-CAMPUS ACTIVITIES Field studies are an integral part of the Summer High School Prep Program. It is important that we have parental permission for students to participate fully in the High School Prep Program, both on campus and away from the school site. This permission form covers normal off-campus school trips during the regular program from Monday to Friday from 9:00am to 4:00pm from July 6, 2015 to August 21, All field trips will take place during the regular program day, during regular program hours and will be located in the Metro Vancouver Area. Supervision of the students will be direct and indirect depending on the nature of the activity. Most field trips will also be supervised and/or led by a workshop facilitator at the field trip destination in addition to the Alexander Academy or IH teacher. Risks: There are inherent risks associated with all field trips and forms of transportation including: o injuries or even death resulting from motor vehicle accidents occurring during travel to, at, or from the field trip site; o Injury or even death resulting from acts of nature, such as earthquake, or fire; o Injury from improper use of props or displays at field trip site; o Damage or vandalism to, or theft or loss of personal property; Transportation: Transportation to field trip sites will be arranged using one or more of several means of transportation: o Walking o Public Transport (including the Sea Bus, Skytrain, Canada Line, bus) o A chartered school bus driven by a school bus driver (e.g. Lynch Bus Lines) Revised March 2015

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7 REFUND AND CANCELLATION POLICIES 1. Non-refundable fees The medical insurance fee is non-refundable. 2. Program Changes Students who wish to postpone their start date may do so with a minimum two weeks prior written notice. Please note the end date of the program is August 21 st and all paid weeks of the program must be completed prior to the end of August 21 st, In the event of postponement and the student being unable to complete all previously purchased weeks of the program due to the restriction of the length of program, the % refunded for weeks not attended will be in accordance to the Cancellation Policy. Weeks of study may not be downgraded once they have commenced except in the event of postponement. Weeks of study may be increased based on availability and with two weeks notice. 3. Rejection by Immigration Canada Students unable to obtain a visa are entitled to a full refund less all non-refundable fees. Students must request a refund in writing four weeks prior to the start of their course and submit a copy of the rejection letter issued by Immigration Canada as soon as possible, otherwise the cancellation policy will apply to the refund. 4. Cancellation Date of cancellation % refunded 30+ days prior to start date 75% 7 to 29 days prior to start date 50% 0 to 6 days prior to start date 35% After 0% to 20% of program 25% After 20% or more of program 0% NB: Program refers to the total number of weeks for which the student is registered. If a student is registered for 4 weeks, the program length is 4 weeks. BANK INFORMATION Bank Name: Account Name: Bank of Montreal Alexander Academy Corporation Account Number: Swift Code: Bank Address: BOFMCAM2 Burnaby Main Office # Kingsway, Burnaby, BC V5H 0A3 Canada