Fillable INTENSIVE ENGLISH PROGRAM APPLICATION (Saint Mary's University, Halifax)

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INTENSIVE ENGLISH PROGRAM APPLICATION (Saint Mary's University, Halifax)

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The Language Centre
Saint Mary’s University, Halifax, Nova Scotia B3H 3C3
Tel: 1.902.420.5691 Fax: 1.902.420.5122
Email: language@smu.ca Web: www.smu.ca/tlc
INTENSIVE ENGLISH PROGRAM APPLICATION
PERSONAL DETAILS
Last Name (Family Name) First Name
Street Address/PO Box/Rural Route/Lot#
City State/Province Postal Code/ZIP Code Country
Telephone
Date of Birth D D M M Y Y Y Y
Nationality
E-mail
PAGE 1
SESSION SELECTION
SESSION
(please choose)
PROGRAM
(please choose)
Course
Fee
Application Fee /
Deposit (due now)
AMOUNT
ENCLOSED
EAP
EPPC
C$2800*
EAP
EPPC
C$2800*
EAP
EPPC
C$2800*
EAP
EPPC
C$2800*
January 04 to February 26, 2021
March 01 to April 23, 2021
May 03 to June 25, 2021
June 28 to August 20, 2021
August 30 to October 22, 2021
October 25 to December 17, 2021
EAP
EPPC
C$2800*
UBP
C$4300*
January 04 to April 23, 2021
May 03 to August 20, 2021
August 30 to December 17, 2021
UBP
C$4300*
IMM
C$1650*
IMM
C$1650*
How did you hear about us?
Canadian Citizen
Permanent Resident (Landed Immigrant)
Study Visa (International Students)
Other
Gender
Male
Female
Social Media
Friend/Family
In Person
Other
Saint Mary's ID
A 0 0
Email
Tuition Deposit
C$500
EAP
EPPC
C$2800*
January 04 to January 29, 2021
March 01 to March 26, 2021
May 03 to May 28, 2021
APPLICATION FEE WAIVER: DO YOU HAVE A CONDITIONAL LETTER OF ACCEPTANCE FROM
SAINT MARY'S UNIVERSITY? IF YES, NO APPLICATION FEE OF $100 REQUIRED
One time non-
refundable
Application Fee
C$100
Tuition Deposit
C$500
One time non-
refundable
Application Fee
C$100
Tuition Deposit
C$500
One time non-
refundable
Application Fee
C$100
UBP
C$4300*
IMM
C$1650*
ACCOMMODATIONS
Textbook/Resource F ee of $135.00 per semester.
Emergency Health Insurance Fee of $54.00/month or any part of a month plus $5.00 administration fee per semester.
**Indicates non-refundable and non-transferable fees and deposits and are subject to change.
Residence deposits include $25 application fee.
Royal Bank of Canada
5855 Spring Garden Road, Halifax, Nova Scotia, Canada B3H 4S2
Bank Name:
Bank Address:
Branch Transit Number:
03413-003 Account Number: 0000117 Swift: ROYCCAT2
How will you pay?
Card Number:
Expiration Date: M M Y Y Y Y
Name of Cardholder (as it appears on the card)
Signature of Cardholder
Total Amount (from above)
PAGE 2
Do you require residence accommodation?
Application form
included?
Deposit
(due now)
AMOUNT
ENCLOSED
Yes
No
C$1225**
Yes
No
C$1000**
Fall or Winter Residence
Spring or Summer Residence
Airport Reception Service
Yes
No
Do you require homestay accommodation?
Application form
included?
Placement Fee
(due now)
Homestay Placement
Yes
No
Miscellaneous Fees
Fee included?
Total Fee
(due now)
Yes
No
Courier Fee (if you wish to receive your
acceptance documents by courier)
Bank Fee (if you are paying by telegraphic
transfer)
Yes
No
TOTAL
PAYMENT
Deposits may be paid to Saint Mary's by CIBC International Student Pay, telegraphic transfer, personal cheque, Traveler’s Cheque, Visa, MasterCard,
American Express or debit card. For those paying fees by CIBC International Student Pay, please go to http://www.smu.ca/academics/payment-
methods.html#CIBC to make your payment. A tuition
deposit of $500 is required upon registration. The balance of all fees is due 30 days before the start
of the session. If paying by telegraphic transfer, please remit funds to Saint Mary's University using the following bank information:
*Mandatory Program Fees:
Credit Card:
Visa
MasterCard
American Express
I am sending money by telegraphic transfer
I am sending money by CIBC International Student Pay
I have enclosed a cheque or money order
I am enclosing credit card information (see below)
Total
C$35**
C$10**
C$100**
C$100**
C$300**
C$35**
C$10**
CVV:
click to sign
signature
click to edit
REGISTRATION POLICY
Please read carefully
To apply for the Intensive English Program, students must pay a $100.00 non-refundable and non-transferable application fee. A $500 tuition deposit
is required for all programs. All remaining tuition and other fees are due 30 days before the start of each semester. Students applying after the 30-day
period must pay all fees in full on registration.
REFUND POLICY
Please read carefully
Until the start of any semester, students who notify The Language Centre of their withdrawal in writing will receive a refund of their tuition fees paid,
less a one-time $500.00 administration fee with the following exceptions:
1. If a student withdraws because they have been denied a visa or study permit, Saint Mary’s will refund tuition fees paid, less the C$100 application
fee. A copy of the letter stating the visa denial must be provided to the Language Centre before a refund can be made.
2. If a student withdrawal in writing after the start of a semester, the following refund schedule will apply:
75%
50%
Up to Friday, Week 1
Up to Friday, Week 2
Up to Friday, Week 3
25%
Applicant Signature (unsigned applications cannot be considered) Date
Send the completed application and payment to the address below:
The Language Centre
Saint Mary's University
Halifax, Nova Scotia
Canada B3H 3C3
Telephone: 1-902-420-5691
Facsimile: 1-902-420-5122
E-mail: language@smu.ca
www.smu.ca/
tlc
PAGE 3
There will be no refunds after Week 4 in any given semester.
Un-utilized insurance will be returned to the student who withdraws from the program without using the services or making any claims at all, i.e $54
for each month yet to commence, No refund is available for any month that has commenced.
No refunds are available on the textbooks. No refunds will be paid to sponsored or scholarship students.
Refunds will be returned using the same method of payment used to pay the original fees. Cash payments will be refunded by cheque. Wire transfer
charges will be deducted from the amount due to the student as stated above. Payments made using CIBC International Student Pay will be
refunded using the original reference code.
Refund Policy: Residence
Application for Residence does not guarantee acceptance. Acceptance is conditional upon available space. If accommodation is not available, the
deposit will be refunded. The application fee of C$25.00 is non-refundable. Students will be notified of their status as soon as possible. Once students
have received their Residence confirmation from the Language Centre, the Residence deposit is non-refundable.
PLEASE NOTE: ALL FEES ARE SUBJECT TO CHANGE WITHOUT NOTICE
CITIZENSHIP AND IMMIGRATION CANADA Please read carefully
If applying for a Study Permit from Citizenship and Immigration Canada, you will be asked to report the DLI# for The Language Centre
at Saint Mary’s University.
The DLI for EAP, EPPC and IMM is: 019347769972
The DLI for UBP, Pre-MFIN and MPP is: 019021279692
Saint Mary’s University will collect, use, and disclose personal information to Citizenship and Immigration Canada, Canada Border Services
Agency, and the NS Department of Labour and Advanced Education only to the extent that such disclosure is necessary for the operation,
implementation and administration of the program for which the information has been originally collected.
CERTIFICATION
I have read and fully understand all the criteria and policies regarding acceptance into the IEP program. I certify that the information contained in this
application is correct to the extent of my knowledge and belief.
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INTENSIVE ENGLISH PROGRAM APPLICATION (Saint Mary's University, Halifax)

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Completed 5 February 2021

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