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Application form

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Kunal Sachar
Kunal Sachar

This document is an application form for students wishing to take ESL or secondary school credit courses at Birmingham International College of Canada (BICC). The 3-page form requests personal details of applicants, including name, date of birth, address, citizenship status, and proposed courses. Applicants must submit documents including photo identification, academic records, immigration documents, and passport photos along with the completed form. By signing, the applicant agrees to provide truthful information and to abide by the rules of BICC, and acknowledges that fees will only be refunded if a student visa is denied by Canadian authorities.

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Send the completed form and Documents to : 410, Tower 5, BICC BIRMINGHAM INTERNATIONAL COLLEGEDhakoli, Mohali, Punjab, India, Motia Heights, K-area Road, OF CANADA 160104 2221 Yonge St. Suite 203 Toronto, Ontario, Canada M4S 2B4 Tel: 416-481-8866 Fax: 416-481-3511 Email: info@bicc-edu.com Web:www.bicc-edu.com This form is to be used by students who wish to take ESL/Ontario Secondary School credit courses at BICC. APPLICATION FORM 1. PERSONAL DETAILS ATTACH PHOTO HERE Title: Mr Miss Ms Mrs Other: Date of Birth Family name: DD / MM / YY First name: Gender: Middle name: Other names: Male Female 2. CONTACT DETAILS Email Address: Home telephone number: Work/mobile telephone number: Demand Draft Number:(850/-Rs) My residential address My mailing address(if different from my residential address) City: State: Province: State: City: Province: State: Country: Post code: Country: Post code: 3. IMMIGRATION STATUS OF APPLICANT (Please tick on CITIZEN) Citizen Permanent Resident Temporary Resident Student Visa Other, detail: 4. ACADEMIC BACKGROUND (If appearing in class 12th please tick documents to follow) Date Institute Documentation Attached To Follow Attached To Follow Attached To Follow Attached To Follow 5. PROPOSED COURSES CENTRE (PLEASE TICK ONLY ONE) . CHOOSE EXAMINATION Term Applying CHOOSE THE CENTRE CLOSESTFall YOUR HOME TOWN Winter Summer TO Year: Grade NEW Course Title DELHI BANGLORE Grade Course Title CHANDIGARH CHENNAI MUMBAI JAIPUR GWALIOR KOLKATA 6. DOCUMENTARY EVIDENCE AND SUPPORTING INFORMATION Please ensure the following documentation is attached to your application, the application will not be processed without required documents. SELF ATTESTED COPY OF PHOTO from Driving license / voter id / pan card / school id card / college id card Certified copy of the your academic record ID.( your previous institution 2 Copy of your Immigration documentsIN ADDITION TO THE ONE PASTED ON THE FORM PASSPORT SIZE PICTURES 7. STUDENT DECLARATION I hereby certify that information entered above is correct and complete. I understand that false information will invalidate this application. I authorise the College to obtain I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT. ANY WRONG INFORMATION information concerning my academic record from any school, university or other institution attended by me. I am aware that tuition fees will be refunded ONLY if I am refused WILL INVALIDATE THIS APPLICATION a Student Visa by the Canadian Authority. If I am accepted as a student at BICC, I hereby agree to abide by all the rules and regulations of the College. BICC collects, stores and uses personal information only for the purposes of administering student and prospective student admissions, enrolment and education. The information collected isSignature of the applicantto third parties without your consent, except to meet government, legal or confidential and will not be disclosed Date: other regulatory authority requirements. _________________ Signature: Date: / / OFFICE USE ONLY Copy of Immigration documents received date: / / Official Stamp Other supporting documents received date: / / Remark: I HAVE CONSIDERED THIS APPLICATION AND I RECOMMEND THAT THE APPLICATION BE APPROVED Officer to sign: Date: / / REJECTED DEMAND DRAFT to be made in favour of MARITIME SCHOLARSHIP CONSULTANTS PVT. LTD. (Payable at CHANDIGARH) Amount 850/- RS

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Application form

  • 1. Send the completed form and Documents to : 410, Tower 5, BICC BIRMINGHAM INTERNATIONAL COLLEGEDhakoli, Mohali, Punjab, India, Motia Heights, K-area Road, OF CANADA 160104 2221 Yonge St. Suite 203 Toronto, Ontario, Canada M4S 2B4 Tel: 416-481-8866 Fax: 416-481-3511 Email: info@bicc-edu.com Web:www.bicc-edu.com This form is to be used by students who wish to take ESL/Ontario Secondary School credit courses at BICC. APPLICATION FORM 1. PERSONAL DETAILS ATTACH PHOTO HERE Title: Mr Miss Ms Mrs Other: Date of Birth Family name: DD / MM / YY First name: Gender: Middle name: Other names: Male Female 2. CONTACT DETAILS Email Address: Home telephone number: Work/mobile telephone number: Demand Draft Number:(850/-Rs) My residential address My mailing address(if different from my residential address) City: State: Province: State: City: Province: State: Country: Post code: Country: Post code: 3. IMMIGRATION STATUS OF APPLICANT (Please tick on CITIZEN) Citizen Permanent Resident Temporary Resident Student Visa Other, detail: 4. ACADEMIC BACKGROUND (If appearing in class 12th please tick documents to follow) Date Institute Documentation Attached To Follow Attached To Follow Attached To Follow Attached To Follow 5. PROPOSED COURSES CENTRE (PLEASE TICK ONLY ONE) . CHOOSE EXAMINATION Term Applying CHOOSE THE CENTRE CLOSESTFall YOUR HOME TOWN Winter Summer TO Year: Grade NEW Course Title DELHI BANGLORE Grade Course Title CHANDIGARH CHENNAI MUMBAI JAIPUR GWALIOR KOLKATA 6. DOCUMENTARY EVIDENCE AND SUPPORTING INFORMATION Please ensure the following documentation is attached to your application, the application will not be processed without required documents. SELF ATTESTED COPY OF PHOTO from Driving license / voter id / pan card / school id card / college id card Certified copy of the your academic record ID.( your previous institution 2 Copy of your Immigration documentsIN ADDITION TO THE ONE PASTED ON THE FORM PASSPORT SIZE PICTURES 7. STUDENT DECLARATION I hereby certify that information entered above is correct and complete. I understand that false information will invalidate this application. I authorise the College to obtain I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT. ANY WRONG INFORMATION information concerning my academic record from any school, university or other institution attended by me. I am aware that tuition fees will be refunded ONLY if I am refused WILL INVALIDATE THIS APPLICATION a Student Visa by the Canadian Authority. If I am accepted as a student at BICC, I hereby agree to abide by all the rules and regulations of the College. BICC collects, stores and uses personal information only for the purposes of administering student and prospective student admissions, enrolment and education. The information collected isSignature of the applicantto third parties without your consent, except to meet government, legal or confidential and will not be disclosed Date: other regulatory authority requirements. _________________ Signature: Date: / / OFFICE USE ONLY Copy of Immigration documents received date: / / Official Stamp Other supporting documents received date: / / Remark: I HAVE CONSIDERED THIS APPLICATION AND I RECOMMEND THAT THE APPLICATION BE APPROVED Officer to sign: Date: / / REJECTED DEMAND DRAFT to be made in favour of MARITIME SCHOLARSHIP CONSULTANTS PVT. LTD. (Payable at CHANDIGARH) Amount 850/- RS