SMEA * 入学申し込み



English Education for Medical Professionals


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>>　入学申し込み

入学申し込み

スタンレーアカデミーへのご入学をご希望の方は、下のフォームにご記入の上、送信ボタンを押して下さい。こちらから、受領確認のメール、および学費振込先などをお知らせ致します。ご質問等がありましたら、ご遠慮なくメールにてお問い合わせ下さい。
全てのコースが４週間以上から申し込みをして頂けます。（毎週月曜日入校可）
日本語でのお問い合わせは：sa@stanleyacademy.caまでどうぞ。

Download School Application Form (PDF)

Download Homestay Application Form (PDF)

SCHOOL APPLICATION

	Mr. Ms.
Family Name
First Name
Date of Birth	Month Day Year
Nationality
Native Language
Email Address
Home Address
City
State / Prov
Zip / Postal
Country
Telephone Number
Fax Number
Emergency Contact Number
Your Occupation
Status in Canada	Citizen Landed Immigrant Visitor Student Working Holiday Other (Specify)

Where did you find out about our school?
Brochure	(Specify)
Search Engine	(Specify)
Media	(Specify)
Agency	(Specify)
	Agency Fax#
	Agency Phone#

COURSE INFORMATION

Please check boxes that apply to you
(Classes start every first Monday of each month)

Language Level:

Beginner
Intermediate
Advanced

Program:

Medical English Full-time Program (ESL)
Medical English Morning Part-time Program (ESL)
Medical English Afternoon Part-time Program (ESL)
Canadian Medical Experience Diploma Program (16 Wks Curriculum)

Preferred start Date:
Every Monday (Canadian Holidays)
Number of Weeks:
	(Minimum 4 Weeks for Medical English Full-time Program) (Minimum 6 Weeks for Medical English Part-time Program)

HOMESTAY INFORMATION

Do you want to apply for Homestay?	Yes No
Do you smoke?	Yes No
Do you have any allergies?	Yes No
If yes, specify
Do you have medical insurance?	Yes No
If yes, name company
Do you prefer a home with children?	Yes No
Do you like pets?	Yes No
Students from other countries OK?	Yes No
What are some of your hobbies?

Please write to your host family and give them more information about yourself after you are placed. Please note that there is no guarantee we will be able to accommodate all of your requests. However, our homestay department will do their best to ensure that as many of the requests as possible are matched.

Arrival Date	(Month/Day/Year)
Arrival Time	am pm
Arrival Flight #
Departure Date	(Month/Day/Year)
Departure Time	am pm
Departure Flight #
Homestay Check-in Date	(Month/Day/Year)
Homestay Check-out Date	(Month/Day/Year)

CONTRACT

I declare that the information I have given is correct and accurate. I have read and understand the school policies as listed on the form. I understand that no guarantee can be given that all my accommodation preferences will be met.

Student Name (or parent's name if student under 18)

Date (m/d/y)

Please check your application again before you press "Send Now".