Apply: Coomeva Vacation Program

    Applicant Information
    First Name:
    Last Name:
    Gender:
    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:


    Application Information
    Please select desired program and start date:

    If you are travelling with a friend or relative, and would like to reside in the same homestay, please tell us this person's name:

    Do you smoke?
    Are you comfortable with pet(s)?

    Do you have any allergies?
    If yes, please explain:

    If you would like to provide us with other information, please use the space below:


    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. Students will also be registered for Insurance at an additional cost of $60.00 fir this program.

    * 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.