Summer Program Application

Student Information
(Please enter your name as it appears on your passport)
Student's Passport Surname *
Student's Passport Given Name(s) *
Preferred First Name
Home Phone(nnn-nnn-nnnn) *
Student's Email *
(Number and Street - specify Street, Road, Crescent, etc.)
Home Address *
Address 2
City *
Province / State *
Postal / Zip *
Country *
Date Of Birth(yyyy/mm/dd) *
Gender * Male Female
Emergency Contact Person
(other than parent)
Last Name *
First Name *
Phone(Home nnn-nnn-nnnn) *
Phone(Business nnn-nnn-nnnn)
Academic Information
Present School *
Phone (nnn-nnn-nnnn)*
Fax (nnn-nnn-nnnn)
(Number and Street - specify Street, Road, Crescent, etc.)
Address *
Address 2
City *
Province / State *
Postal / Zip *
Country *
Guidance Counselor/Advisor
Parent/Guardian Information
Mother:
Mother's Last Name
Mother's First Name
Phone(business nnn-nnn-nnnn)
Email
Address information same as student
Phone (nnn-nnn-nnnn)
(Number and Street - specify Street, Road, Crescent, etc.)
Address 1
Address 2
City
Province / State
Postal / Zip
Country
Father:
Father's Last Name
Father's First Name
Phone(business nnn-nnn-nnnn)
Email
Address information same as student
Phone (nnn-nnn-nnnn)
(Number and Street - specify Street, Road, Crescent, etc.)
Address 1
Address 2
City
Province / State
Postal / Zip
Country
Summer Course Selection for 2012
From the courses listed below, choose your first, second and third choices:
First Choice:
Program:
Course Name:
Second Choice:
Program:
Course Name:
Third Choice:
Program:
Course Name:
Are you a Canadian citizen who holds a Canadian passport?
Rewards Program
Referred by (if applicable):  
How did our hear about ?

TRIP CANCELLATION PROTECTION PLAN

Optional trip cancellation protection is available to summer students for $195.00 (this protection must be purchased at the time of application.)

It serves as a safeguard for the refund of monies paid to MEI International Academy if a student is forced to cancel booking, before departure, due to serious illness or injury such that the attending doctor states it is unwise to travel, or if a life-threatening illness, injury or death occurs to an immediate family member.

The plan does not cover pre-existing illnesses.
The trip cancellation protection fee is nonrefundable.

* I will purchase the cancellation protection.

Yes, for Summer Program ($195.00)
No Thank You

* MEI International Academy reserves the right to change the itinerary and prices when circumstances deem it necessary. It also reserves the right to terminate a student's participation in a program due to actions or behaviour deemed unacceptable to the administration, as outlined in the MEI International Academy Discipline Code.

DEPOSIT PAYMENT

A $1095.00 deposit must be received by MEI International Academy within seven days of submitting this application. (your $1000.00 deposit includes a $95.00 non-refundable registration fee)

Pay by Cheque.

Pay using Paypal.

PayPal includes Visa, MasterCard.
(Paypal account not required.)

If you are not accepted into the program, your deposit will be refunded in full. Once a student accepts an offer of participation into our program, the deposit and payments are non-refundable.

PAYMENT INFORMATION
Your invoice will be posted on the Student Login with your Acceptance Package. The payment schedule will vary depending on your acceptance date. Contact our office regarding payment schedule details.

EXTENDED FLIGHT ARRANGEMENTS
Students who require alternate flight arrangements, must notify MEI upon acceptance by completing and returning the Extended Travel Request form in the Acceptance Package by March 1st, 2011. Travel extensions that are requested after March 1st, 2011 cannot be processed. A deviation fee will be applied to your invoice at the time of ticketing.