Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone * Organization the Funding Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920What is your current status in Canada? (For Funding Eligibility) *Canadian/PR/RefugeeCUAETInternational StudentWork Permit HolderVisitor Visa HolderWhich Language Program are you interested in? *Selis English Language ProgramSelis French Language ProgramChoose the Course *Selis Comprehensive English & Everyday CommunicationSelis Basic English for BeginnersSelis Basic English for Intermediate levelSelis Basic French for BeginnersSelis Basic French for Intermediate levelSelis Conversational EnglishSelis Conversational FrenchSelis CLB Prep (IELTS)Selis CLB Prep (CELPIP)Selis CLB Prep (PTE)Selis CLB Prep (TEF)Selis CLB Prep (TCF)Selis Medical EnglishSelis Business EnglishChoose the Method of Delivery: *I can do Online ONLYI want to study in-person ONLYI am flexible and I can do bothChoose your preferred times of the day *I can attend Weekday Morning classes ONLYI can attend Weekday Afternoon classes ONLYI can attend Weekday Evening classes ONLYI am flexible and I can attend anyAnticipated Start Date *Are you Referred by a Partner Organization? *YesNoName of Referring Organization: *Name of Referring Organization Advisor: *Email of Referring Organization Advisor: *Phone Number of Referring Organization Advisor: *Submit
