Page 1 of 2SECTION A : PERSONAL INFORMATIONGender*MaleFemaleName*Date of Birth*Country of Citizenship:*Please selectAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCote D'IvoireCroatia (Local Name: Hrvatska)CubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard And Mc Donald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic Of)IraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic OfKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedonia, Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic OfMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts And NevisSaint LuciaSaint Vincent And The GrenadinesSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia, South Sandwich IslandsSpainSri LankaSt. HelenaSt. Pierre And MiquelonSudanSurinameSvalbard And Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic OfThailandTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis And Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabweStatus in Canada*Canadian CitizenPermanent ResidentStudent Authorization(visa)OtherUpload your scanned Passport*Current Address*City*Email address*Postal Code*SECTION B : ENROLMENT INFORMATIONThis student is applying for the following terms: *September to June (Full Year)January to December (Full Year)March to February (Full Year)September to December (Fall Semester)January to February (Winter Semester)March to June (Spring Semester)Summer School (July/August)School Grade (In Canada) *Gr.9Gr10.Gr.11Gr.12SECTION C : CUSTODIAN INFORMATIONCustodian*YesNoCustodian NameCustodian Email addressCustodian TelCustodian AddressSECTION D : OTHER SERVICESPlease choose other services if you want to request W.H.S to arrange for you. Residence HomestayMedical Insurance Custodian LetterAirport Pick-up ServiceNext REFUND POLICY FOR TUITION FEEA full refund, excluding the administration fee ($500) and application fee ($200), will be granted if Citizenship and immigration Canada does not issue the Study Permit. To obtain a refund, the student must provide: 1. The original Letter of Rejection from Citizenship & Immigration Canada 2. The original Willowdale High School Official Letter of Acceptance 3. The original receipt of tuition fee payment Two – thirds (2/3) of the tuition fee will be refunded, if the student has not applied for a Study Permit and has withdrawn the application prior to the commencement of school. To obtain a refund, the student must provide: 1. The original Willowdale High School Official Letter of Acceptance 2. The original receipt of tuition fee payment There will be no refund of tuition fee after a Study Permit has been granted using the Willowdale High School Official Letter of Acceptance, if the student chooses to withdraw for any reason. There will be no refund of any portion of the tuition fee that has been paid to Willowdale High School once the student has started attending classes or the semester has begun while the student has been in Canada. There will be no refund of the tuition fee if the student is found in violation of school regulations and asked to withdraw from the school. There will be no refund of the tuition fee if the student changes immigration status during the year. A student who becomes a Permanent Resident of Canada after tuition fee is paid is not eligible for a refund.GENERAL RELEASE/WAIVERStudents must comply with all Willowdale High School policies and the student Code of Conduct. Failure to follow school policy or to comply with the conditions will result in the student being suspended or expelled. No refund will be granted if students are suspended or expelled for any of the above reasons. Student photographs, videotaped images and activities, voice recording, artwork, writing or other school works may be recorded, displayed or used in board and school specific internet web pages for documentation and presentation purposes of Willowdale High School. I/We consent to the use of the above noted records and images by Willowdale High School. I/We fully understand the refund policy of the Willowdale High School. I/We understand that the Willowdale High School shall not be held liable for losses or expenses as a result of the school being unable to provide education owing to labour disputes or other causes beyond its control. I confirm that I have read and accept the Conditions of Enrolment as well as the Refund Policies and General Release/Waiver of Willowdale High School as stated on the upper side of this form. I will be committed to attending each class on time and will inform the school at least 5 days in advance if I am unable to attend.Student Signature(18 years or older)/Parents or Guardian *Date*BackSendThis field should be left blank