Application – TESOL Certificate Applicant Information First Name: Last Name: Gender: ---MaleFemale Date of Birth: Native Language: Country of Nationality: E-mail Address: Canada Address and Contact Information Street Address: City, Province, Postal Code : Phone Number: Fax Number: Country Address and Contact Information Street Address: City, Province, Postal Code : Country: Phone Number: Fax Number: Course Information Select Start Desired Start Date: ---January 7, 2019 (4-week full-time)February 12, 2019 (11-week part-time)May 6, 2019 (4-week full-time)June 3, 2019 (4-week full-time)July 29, 2019 (4-week full-time)September 09, 2019 (4-week full-time)October 8, 2019 (11-week part-time) Academic Background Information Are you 18 years old or older? ---YesNo Note: Applicants must be at least 18 years of age from the starting date of the program. All applicants will be required to provide proof of age prior to starting the program. Have you completed a secondary school diploma or GED?---YesNo Note: An OSSD or equivalent is required for admission to the TESOL Certificate program. You will be required to submit proof of this requirement prior to receiving an offer of admission. (Secondary school diplomas from outside of Canada or GED certificates are acceptable, provided that they are equivalent to a secondary school diploma from Ontario.) Have you completed a university degree?---YesNo University Degree: Major: Date of Completion: Granting Institution: Payment Information A CAD$100 non-refundable deposit is required to process your application and issue a letter of acceptance. Click “Submit now!” to submit your application. You will then be redirected to our secured online payment page to make your $100 deposit. * London Language Institute will be in contact with you within 3 business days. ** Please contact our office if you require an original letter of acceptance couriered to you. *** Fees for this service vary and we can provide you with this service if required.