INTERNATIONAL
Within Reach. Beyond Imagination. 1 888 953 1133 selkirk.ca
AIRPORT PICKUP
CASTLEGAR FORM
By applying for the Airport Pickup Services you are comitting to use the services. Once you
apply the service, there is no cancelation and refund allowed. This $100 service includes:
airport pickup, help with grocery shopping, and setting up a bank account.
I understand that by making this application I will pay the Airport Pickup Services fee of $100 to Selkirk College with this application. I also understand
that there will be no refunds or cancelations.
I have read and undertood the Homestay Application Form and I agree to the conditions described above.
Submit this complete form and the $100 fee to Misoon Jang mjang@selkirk.ca. You will receive the Airport Pickup Services contact information.
Student Name: Canadian given name (if desired):
Student Number: Nationality:
Date of Birth (yy/mm/dd): Gender:
Email: Arrive Time & Date:
Destination Address:
Student SignatureStudent Name Year / Month / Date
PAYMENT OF AIRPORT PICKUP SERVICE FEE
THE $100 FEE MUST BE SUBMITTED WITH THIS FORM. PAYMENT CAN BE MADE BY MONEY ORDER, BANK TRANSFER OR CREDIT CARD.
Student Name:
Student Number:
If you wish to pay by credit card please complete the following information.
CREDIT CARD DETAILS:
VISA
MASTERCARD
I authorize Selkirk College to charge Airport Pickup Services fee of $100 to my credit card.
Cardholder Signature
Card NumberName on card Expiry Date
click to sign
signature
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