Loyola ESL Registration Form
2022-2023
Loyola Site
*
Please Select
Belleville
Kingston
Your English level
Please Select
Beginner
Intermediate
Advanced
Preferred study day plan
*
Mornings
Afternoons
Night school
Preferred study style
*
In person
Online
Student Information
First name Last name
*
Address
Street Address
Street Address Line 2
City
Province
Postal
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Emergency Contact email
example@example.com
Date of Birth
*
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Day
/
Month
Year
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Gender
*
Please Select
Male
Female
Undisclosed
Date of Entry to Canada
-
Day
-
Month
Year
Status in Canada
Permanent Resident
Canadian Citizen
Refugee Claimant
Approved Refugee
Visitor
CUAET
Other
What country do you come from?
What is your first language?
What was your job in your home country?
What is your highest school level?
Have you studied English before?
How did you hear about our school?
Friend
Website
Settlement Office
Other
Submit
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