ADMISSIONS APPLICATION

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High school or post-secondary certificate or transcript

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Application form (Please type this form)$200 Application Fee (non-refundable)Passport (Copy of page with picture)

□ Official English Score as required by your chosen program

Payment Plan:

YES NO

ACE (English Program):

Arbutus Student Number:______________________

Proposal Number: _____________________

Full Name:

Middle Last

Gender: female male

First

Birthdate (DOB):

Street Address Apartment/Unit #

City Province Country ZIP Code

Skype: Email

EDUCATION

High School/College/Other: City: Country:

From: To: YES

Did you graduate? NO

Highest achievement:

AGENT INFORMATION

Agent Name:

Agency:

Address:

PAYMENT

Bank name: Bank Address: Account Name:

RBC Royal Bank Of Canada (Hastings & Granville Branch) 685 West Hastings St, Vancouver, B.C., V6B1N9 Arbutus College of Communication Arts, Business & Technology

I would like my payment to be made:

Date:

Promotion Code:

Academic Term: months

Academic Term: months months

APPLICANT INFORMATION

Directly to the College OR through my agency

I certify that my answers are true and complete to the best of my knowledge.

REQUIREMENTS & DOCUMENTS CHECKLIST

PROGRAM CHOICE

Co-op Term:

Transit: 06550 Institution: 003 Account: 1043066 Swift Code: ROYCCAT2

Address:

Career Program:

English Program Start Date:

Career Program Start Date:

All payments may be made by bank transfer, credit card or International money order.If paying by money order add an additional fee of $30 and send a payment proof to myinfo@arbutuscollege.com; be certain to include the student's full name.

DISCLAIMER AND SIGNATURE

Signature:

IELTS score: Other:

Account Manager: ___________________________

Phone:

DLI#O19219834012

Email:

Phone:

Does the agency require an agent quote?YES NO

Comment :

Nickname

Pathway Program, ARBUTUS + ACSENDA:

NO YES

REFUND POLICY

1) A student may be entitled to a refund of tuition fees in the event that:

(a) The student provides written notice to the institution that he or she is withdrawing from the program;

(b) An international student delivers a refusal of study permit; or

(c) The institution provides written notice to the student advising that the student has been dismissed from the program.

2) The written notice of withdrawal or dismissal may be delivered in any manner provided that a receipt or other verification is availablethat indicates the date on which the notice is delivered.

3) The notice of withdrawal or dismissal is deemed to be effective from the date it is delivered.

4) The refund to which a student is entitled is calculated on the total tuition fees due under the contract. Where total tuition fees have notyet been collected, the institution is not responsible for refunding more than has been collected to date and a student may be required to make up for monies due under the contract.

5) If the institution has received fees in excess of the amount it is entitled to under the student contract, the excess amount must be refunded.

6) Refund policy for students:

a) Refunds before the program of study begins:

• If written notice of is received by the institution for any of the circumstances listed on 1) above, no later than 7 days after theeffective contract date, and before the program start date, the institution will refund 100% of tuition;

• If written notice is received by the institution for any of the circumstances listed on 1) above, between the date the contractwas signed and the start of the program, where that period is less than 7 days, the institution will refund 100% of tuition;

• If written notice is received by the institution for any of the circumstances listed on 1) above, more than 7 days after theeffective contract date, and at least 30 days before the program start date, the institution may retain up to 10% of tuition to amaximum of $1,000.00;

• If written notice is received by the institution for any of the circumstances listed on 1) above, more than 7 days after theeffective contract date, and less than 30 days before the program start date, the institution may retain up to 20% of tuition toa maximum of $1,300.00;

b) Refunds after the program of study starts:

• If written notice is received by the institution for any of the circumstances listed on 1) above, after the program start date, butbefore 10% of instruction hours have been provided, the institution may retain up to 30% of tuition;

• If written notice is received by the institution for any of the circumstances listed on 1) above, after the program start date, andbetween 10% and 30% of instruction hours have been provided, the institution may retain up to 50% of tuition;

• If a student withdraws or is dismissed after 30% of instruction hours have been provided, no refund is required.

c) Where a student did not meet the institutional and/or program specific minimum requirements for admission through nomisrepresentation or fault of their own, the institution must refund all tuition and fees paid under the contract.

d) Where the institution does not provide all the work experience hours of a program (if applicable) within 30 days of the contract end date, and the student does not attend the work experience, the institution must refund all tuition and fees paid under the contract.

7) If a refund is due and the student has paid for but not received textbooks or other course materials, including equipment or uniforms,the institution must also refund the fees charged for these items.

8) If a student has received Application Fee waived promotion, in case of a withdrawal or course cancellation, the institution may keep$200 from the funds received. Standard tuition refund policy will apply in addition to the $200 value of the application fee.

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