Design Program Application Form Online Application Form (Recommended) Download application form (you need to print it out and send it by Fax or mail)
*First Name:
*Last Name:
Date of Birth:
	Male      Female
Status in Canada:	Canadian Citizen Landed Immigrant Study Permit Visitor Working Holiday Other
Permanent Address
*Street & Apt #:
*City & Province or Territory:
*Postal Code:
*Country:
*Email:
*Telephone:
Fax:
Cell Number:
*First Language:
Programs
*Registration Fee for Design Program	--- Registration Fee --- International Student - $200 Citizens or Immigrant Student - $150
*Program Selection	--- Program Selection --- Fashion Design - 75 weeks Interior Design - 45 weeks Digital Media Design - 45 weeks Jewellery Design - 45 weeks Fashion Marketing (Online) - 56 weeks Multimedia Techniques (Online) - 42 weeks Interior Design (Online) - 56 weeks
Start dates for Design Programs are: January, May, and September.
*Start Date:	--- Start Date --- Jan 14th 2008 May 12th 2008 Sep 8th 2008 Jan 12th 2009 May 11th 2009 Sep 8th 2009
Additional Information
How did you hear about our school?:	--- How did you hear about our school? --- Google Yahoo! MSN Another Search Engine An agent TV LaSalle College Student Advertisement in Magazines Advertisement in Newspapers Friends Phone book Bus or Skytrain LaSalle College Montreal Others
Details:
Accomodation
Choice of accommodation:	--- Choice of accommodation --- No thanks. I don’t need accommodation Homestay (No meal, $640 / 4 weeks) Homestay (2 meals, $800 / 4 weeks) Homestay (3 meals, $900 / 4 weeks)
Registration Fee for Homestay : $200
Accomodation starting date:
Weeks
Do you smoke:	Yes No
Do you have any allergies?	Yes No
If yes, please explain:
Do you take any medications?	Yes No
If yes, please explain:
Do you have any special dietary requirement?	Yes No
If yes, please explain:
Can you live with pets?	Yes No
Can you live with children under 13?	Yes No
Airport Services
Do you require airport service?	Yes – 1 way (Pick-up: $110) Yes – 2 ways (Pick-up & Drop-off: $220) No
Arrivals Flight Date:
Flight Time:
Airlines:
Flight Number:
Medical Insurance (Optional)
Do you require Medical Insurance?	Yes No
$1.75 / day Minimum of 30 days ($1.75 x 30days = $52.50)
Payment Details
Your application cannot be processed without the Registration fee. Registration Fee is NOT refundable.
Comment
	I hereby declare that all the information I have provided is true and correct. I attest to having understood and accepted the conditions for admission and the refund policy of LaSalle College International Vancouver. Click for Refund Policy Details