Preliminary Application form
INSTRUCTIONS
- Fill out the form. - Attach a cheque or a Money Order for $75 (opening file fee non refundable) payable to AFS Interculture Canada. - Make sure your parents sign the form. - Send it to the following address: AFS Interculture Canada 1425 René-Lévesque blvd. West, Suite 1100 Montreal (Québec) H3G 1T7 First name and surname
Gender
Address
No.
Telephone (home)
Day
Birth Date
City
Province
Mobile
Month
Postal Code
Postal Box
School's name
Father's name or guardian
Mother's name or guardian
I'm interested in the following destinations Year of departure
Summer or Winter departure
Type of program
How did you hear about AFS Interculture Canada? If you can, give details (for example, if you indicated "Internet", you may add "google search engine", or if you marked "local newspaper", write the name of the paper and the publication date, if you remember it).
I certify that the information submitted on this form is exact.
Candidate's signature
Date
Parent's or guardian's signature
Date
I encourage my child to pursue her/his application with AFS. I am interested in obtaining information about hosting an AFS student.
Year