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STEP AND LEAP APPLICATION FORM 1. ENROLMENT INFORMATION Which program are you applying to: STEP
LEAP (requires English test score)
I have already submitted a Langara College Application Form, official transcripts,
and paid my application fee. SESSION: September
November
January
March
May
July
Langara Student I.D. Number:
2. PERSONAL INFORMATION – PLEASE PRINT CLEARLY Surname/Family Name:
Date of Birth (dd/mm/yy):
Given or Other Names:
Gender:
Current or Canadian Address:
Citizenship:
Male
Female
First Language:
Status: City: Prov: Country: Postal Code: Tel: Cell: Email:
Canadian Citizen (proof of status required) Permanent Resident (proof of status required) Expiry: Temporary Resident/Visitor Study Permit Other:
3. ACADEMIC RECORD All International Students must enclose official transcripts and graduation document(s) with certified
English Language Test Scores (if known):
English translations. Submitted documents will not be returned. TOEFL:
LPI:
Other:
IELTS:
CAEL:
Name of School: City:
TOEIC:
Other:
Country: Graduation Year:
STEP / LEAP Pretest:
Highest Level of Education: High School
University
4. ACCOMMODATION I would like to stay with a Homestay family. Please send me a Homestay application.
I will arrange my own accommodation.
5. APPLICATION FEE PAYMENT Please include your fee when you submit your application. Canadian Citizens and Permanent Residents $40 Visa
MasterCard
International Students $155
*BANK DRAFTS, MONEY ORDERS or AMERICAN EXPRESS ARE NOT ACCEPTED
Name on Card: Card Number: Signature: Expiry Date (mm/yy):
6. FEEDBACK Where did you first learn about the STEP and LEAP Programs?
Why did you choose Langara College?
7. APPLICATION CHECKLIST Completed application form
Official transcripts and graduation document(s) with certified English translations (for Canadian Citizens/
Application fee
Permanent Residents under the age of 19 and all International Students)
*
For students applying to LEAP only: Official Score Report of English language test *
The application fee is non-refundable. Please refer to the refund policies regarding all other fees. Transcripts and English language test scores will not be returned.
Web: www.langara.bc.ca/international-education
8. DECL AR ATION, CONSENT AND RELEASE 1. Acceptance of this application is not a guarantee of admission. Admission is subject to qualifications and availability of seats. 2. In signing, I certify that all statements on this application and supporting documents are true, complete and valid. I authorize Langara College to verify any information provided as part of this application. I understand that evidence of falsified documents or misrepresentation may result in cancellation of admission or registration. I accept that information on falsified documents is shared with the Association of Registrars of Universities and Colleges of Canada. I understand that personal information on my record is protected in compliance with the appropriate legislation and will only be used for research and statistical purposes subject to the restrictions of the Freedom of Information and Protection of Privacy Act. This includes the provision of name, address, phone number and college program to the Langara College Foundation and Alumni Association, the Langara Students’ Union and the International Education Department. Questions about the collection and use of this information should be directed to the Registrar. 3. In consideration of Langara College permitting me to participate in the STEP or LEAP Program, I hereby release the College, its officers, employees, servants, agents, contractors and subcontractors from any and all claims and waive any and all claims I may have, now or in the future, against the College, its officers, employees, servants, agents, contractors and subcontractors that arise out of or are related in any way to my involvement in the STEP or LEAP Program and all associated activities. 4. I agree to purchase medical insurance to cover my period of study. 5. I have read and understood the above statements. Signature of student, parent or guardian: Date (dd/mm/yy): A parent or guardian signature is required for students under 19 years of age.
9. AUTHORIZED REPRESENTATIVE (OPTIONAL) I have chosen the person stated below to receive all my correspondence and act as my representative until the first day of my session. Relative
Agent
Other:
Name: Agency: Address: City: Country: Postal Code: Tel: Cell:
Email:
Signature of Applicant: Date:
10. EMERGENCY CONTACTS LOCAL
OVERSEAS
Surname/Family Name:
Surname/Family Name:
Given or Other Names:
Given or Other Names:
Current Address:
Current Address:
City: Prov:
City: Prov:
Country:
Country:
Cell:
Postal Code:
Tel:
Email:
Postal Code:
Cell:
Email:
OFFICE USE ONLY STEP or LEAP start date:
Notes: Session:
CRN:
Fees:
Session:
CRN:
Fees:
Session:
CRN:
Fees:
Session:
CRN:
Fees:
Tel:
Approved:
LEAP and STEP, International Education, Langara College 100 West 49th Avenue, Vancouver, BC Canada V5Y 2Z6 Tel: 1-604-323-5286 (STEP) or 1-604-323-5473 (LEAP) or e-mail: step@langara.bc.ca or leap@langara.bc.ca Web: www.langara.bc.ca/international-education