Simon Fraser University - Navitas

AccommodationDo you require accommodation?Yes NoIf “Yes”, what type of accommodation?HomestayOn-CampusOff-CampusAirport receptionDo you require airport pick-up?Yes NoIf you ticked “Yes” above, information will be emailed to you regardingairport pick-up.Request for learning supportIf there is anything that may affect your learning (for example impairmentsto your mobility, sight, hearing, reading or writing), please notify FICand SFU so that we can support you. Please indicate your needs on aseparate sheet of paper and attach to this application.Medical insurance requirementsI understand FIC will provide mandatory twelve (12) months of medicalcoverage upon arrival in Canada. At the end of the twelve (12) monthsI will have an option to extend the initial coverage or apply for the BCMedical Plan.Sponsored students onlyType of sponsorship (ie. tuition fees and/or living expenses):DeclarationI declare that the information I have supplied on this form is, to the best of myunderstanding and belief, complete and correct. I understand that the giving of falseor incomplete information may lead to the refusal of my application or cancellationof enrollment. I have read and understood the published course information in thebrochure or website and I have sufficient information about FIC and SFU to enroll. Igive FIC and SFU permission to obtain official records from an educational institutionattended by me. I grant FIC permission to provide SFU with any information pertainingto my application to study, ongoing academic progress, results and attendance for thepurposes of admission and transfer. I understand that FIC and SFU collects, storesand uses personal information only for the purposes of administering prospective,current and graduate student admissions, enrollment and education and thatthe information collected is confidential and will not be disclosed to third partieswithout my consent, except to meet government, legal or other regulatory authorityrequirements (for further information consult FIC’s Privacy Policy and SFU’s Access toInformation and Protection of Privacy Policy).I understand that if I have applied through an approved FIC and/or SFU agent,all correspondence relating to my application will be forwarded to that agent. Iunderstand that fees may change without notice. I accept liability for payment ofall fees as explained in this brochure, and I agree to abide by the Fee Refund Policywhich is current at the time of my studies at FIC. I understand that this may bedifferent to the Fee Refund Policy as specified in this brochure. I have also read thesection in the FIC brochure relating to costs of living and I understand that livingexpenses in Canada may be higher than in my own country and I confirm that I amable to meet these costs. I understand that after I commence the UTPII program atFIC, I must complete a minimum of 30 units before I can transfer to SFU.I understand that after I commence the UTPII program at FIC, I must complete aminimum of 30 units before I can transfer to SFU.I authorize FIC to give information about my application for student housing to SFUresidence and housing departments pertaining to my accommodation needs. I alsoauthorize SFU residence and housing departments to give information about myapplication for student housing to FIC pertaining to my accommodation needs.Applicant’s signature: (must be the same signature as in your passport)Name of organization sponsoring you:Date: / / (day/month/year)Other informationHow did you first learn about FIC? You may tick more than one.Exhibition/SeminarNewspaper/MagazineRecommended by a friend/relativeRecommended by an education agentInternetOtherPlease specify:Disclaimer (for students 19 years and older)I grant FIC permission to provide my parent(s) or guardian(s), when requested,with any information pertaining to my application to study, ongoing academicprogress, results and attendance.YesNoIf you are under 19 years of age, your parent or guardian must also signthis application form.Parent’s/Guardian’s signature:Date: / / (day/month/year)Postal Address for applications:Admissions OfficerFraser International CollegeSimon Fraser University,Burnaby CampusMTF Building, Discovery ParkSuite 100, 8900 Nelson WayRepresentative’s stampBurnaby, BC, Canada V5A 4W9Phone: +1 778 782 5011Fax: +1 778 782 5101Email: admissions@fraseric.caInternet: www.fraseric.caApplication checklistCheck that you have:Completed all sections of the Application formRead and understood the Conditions of Enrollment including theFee Refund Policy on page 26.Check that you have attached:Certified copies of your academic qualificationsEvidence of your English language ability if requiredA copy of your passport, Study Permit or birth certificate if requiredAny relevant employment documentation if required