APPLICATION FORM 2020

Application
form 2021 .BLI.CA
WWWWWW. BL I. CA

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Personal Information

First name: Last name:

Date of birth (dd/mm/yy): Age: Male Female

Address: Zip code: City:

Province: Country: Email:

Phone: Native Language: Nationality:

Emergency Contact

First name: Last name:

Phone: Cellphone:

Email: Relationship to Applicant:

Course & Program Information

Study location: Montreal Quebec I will be studying in: English French

Weeks of study: Start date (dd/mm/yy): End date (dd/mm/yy):

GENERAL PROGRAMS:

Part time (18 lessons) Full time (24 lessons) Intensive (30 lessons)

Super Intensive (36 lessons) Bilingual (42 lessons)

Private course Exam preparation courses (IELTS, TOEFL, TEFAQ, DELF)

JUNIOR PROGRAMS:

Winter FLAP Spring FLAP Summer FLAP

OTHERS:

Winter vacation program Spring Vacation program Summer Vacation program

Other Services
*It is mandatory to have medical insurance.

Do you need Medical Insurance*: Yes No

If you have other insurance, please specify:

First day of insurance (dd/mm/yy): Last day of insurance (dd/mm/yy):

Do you need Airport Transfer Service? Pick-up Drop-off Both No

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HOMESTAY

Full board (3 meals per day) Single room (no meals) Start date (dd/mm/yy):
Half board (2 meals per day) Shared room (no meals) End date (dd/mm/yy):
Roomstay (No meals)

HOMESTAY CONDITIONS RESIDENCE CONDITIONS

• You must check-in on Sunday and check-out on • A 250 CAD deposit must be collected. 50 CAD will
Saturday. be used as cleaning fee(non-refundable). 200 CAD
• Placement fee is non-refundable. will be reimbursed.

• The first two weeks are non-refundable. • Minimum stay at the residence is one month
-30days-.
• If you decide to leave your homestay, you have to
give at least 2 weeks notice. • Placement fee is non-refundable.

OTHER PREFERENCES (If YES, please specify)

Do you have any allergies? No Yes

Do you take any medication? No Yes

Are you vegetarian? No Yes

Do you have special dietary needs? No Yes

Could you live in a house with children? No Yes

Could you live in a house with pets? No Yes

Do you have any illness? No Yes

Do you have any chronic illness? No Yes

Do you smoke? No Yes

Do you have a special health condition? No Yes

I hereby inform BLI of any medical condition that I might have before or during my study period at BLI. I agree to inform about if any pre-existing medical or health condition
that may require on going or intermittent medical attention or that may affect my ability to participate in either classroom or activity programs. I authorize any doctor or
medical staff/facility to provide treatment to me if I am injured or ill whether or not I am able to provide consent. I acknowledge that BLI may collect personal information
including medical information with this application. During my study period at BLI, I agree that this information will only be used in the course of the provision of educational,
supplementary and medical services only.
By signing this I acknowledge the conditions and policies of BLI.
 APPLICATION FORM 2021

First day of session

April 2nd July 1st

*December 31 alternative start date April 5th September 7th

May 24th October 12th

June 24th December 25th

The
STUDENTS CAN START ANY MONDAY, EXPECT
HOLIDAYS AND LAST WEEK OF THE SESSION.
TRUE BEGINNERS START ON THE FIRST DAY OF

school
THE SESSION.

where the
world
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meets.
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BLI Policies
ADMISSIONS
Students have to submit a valid copy of your passport
and signed application form in order to be admitted to
study at Bouchereau Lingua International in Montreal/
Quebec in Canada.
ADMISSION PROCESS
• Complete the application package
• Pay Registration fee and 30% of tuition fees
• Submit the required admission documents
• Receive letter of acceptance
• Process CAQ and Study Permit (students who want
to study for 6 months or more) (if applicable)
• Process ETA or Visitor Visa (students who want to
study for less than 6 months) (if applicable)
• Once your study permit, ETA or Visitor visa is
approved, send a copy to your admissions
coordinator
• Sign Student Contract
• Validate your documents on your first day
• Start your program
DOCUMENTS CHECKLIST WHEN SUBMITTING YOUR
APPLICATION
• Application package with signature
• Photocopy of your passport. Page that contains
your photo
• Proof of payment
• Copy of CAQ, and Study Permit. Students who want
to study for 6 months or more (if applicable)
• ETA or Visitor Visa. Students who to want study for
less than 6 months (if applicable)
• Student Contract
• Copy of Medical insurance if not obtained through
BLI
LANGUAGE POLICY
English/French-only policy has been established to help
you maximize your language practice during your studies
in Canada. To help you really improve your language
proficiency level, you are expected to communicate
exclusively in the language in which you are studying at
all times while at BLI.
If you break the English/French-only rules, you will receive
a penalty.
1st offence Warning
2nd offence One day suspension
3rd offence Three days suspension
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4th offence Five days suspension
5th offence One session suspension
6th offence You will be suspended officially from the school
REFUND AND CANCELLATION POLICY
All notices regarding cancellations and refunds must be
given in writing by mail or e-mail stating the reason you
intend to withdraw from the program you have registered
for, and they must state valid reasons for the request.
All refunds will be made to the same person to the same
account as they were received(bank transfer, credit card
or direct deposit). The bank and credit card fees
applicable to the payment and refund will be deducted
from the total amount to refund.
CANCELLATIONS
All notices regarding cancellations and refunds must be
given in writing by mail, or e-mail stating the reason you
intend to withdraw from the program you have registered
for. Registration, accommodation placement and
custodianship letter fees are non-refundable.
If you are obliged to cancel your program due to visa
refusal, a complete refund will be made; excluding
registration, accommodation placement and
custodianship letter and bank fees (if applicable)
Note that BLI needs to receive the Original CIC letter of
refusal. No refunds will be issued without that document.
If you registered with BLI using a promotional offer and no
registration fees were charged, an administrative fee equal
to the registration fee will be applied.
PROGRAM CANCELLATION
Before Program Start Date
If you cancel less than ten days after submitting your
registration, no cancellation fee will be charged.
If you cancel 31 days or more before the program starts,
30% of the program tuition fees will be charged.
If you cancel less than 30 days before the program start
date, 40% of the tuition fees will be charged.
If CIC denies your visa, no cancellation fee will be charged.
After Program Start Date
If you cancel within 1% and 10% of the total length of your
program, 50% of the fees will be charged.
If you cancel within 11% and 24% of the total length of your
program, 70% of the fees will be charged.
If you cancel after having completed 25% of your program,
100% of the fees will be charged.
As BLI prices vary based on the length of a program, if
you decide to shorten your program and are eligible for
a refund, the weekly rate may change if the duration of
your program falls under a different price range.
Partially used weeks will be considered as completed
weeks without exception.

If you wish to cancel your program at BLI, you must
demonstrate that it is legal for you to remain in Canada.
Otherwise, you will have to accompany your refund
request with proof that you will leave the country.
Original letter of Acceptance and tuition payment
receipt that proves that you are enrolled in a different
school and that you meet the initial conditions stated in
your visa application. Photocopy of a fully paid and non-
refundable plane ticket showing the return to your home
country.
If you are not able to provide any of these documents
and you want to remain in Canada, you must apply for a
visa status change.
PROGRAM CHANGES
You can upgrade but not downgrade your program. E.g.,
If you want to change from a full-time program to a part-
time program, you will have to cancel the program and
reapply. The cancellation policy will apply.
BLI courses and services are not transferable under any
circumstance.
POSTPONEMENT
If you wish to postpone the start date of your program,
you must notify BLI in advance. BLI will issue a new letter
of acceptance for a later date free of charge if your
program lasts less than 6 months. If your program lasts six
months or longer, you will be charged $70 CAD.
HOMESTAY CANCELLATION POLICY
If you registered with BLI using a promotional offer and no
accommodation fees were charged, an administrative
fee equal to the accommodation placement fee will be
applied. The accommodation placement fee is non-
refundable.
Before Program Start Date
If you cancel four weeks or more before the arrival date,
no cancellation fee will be charged.
If you cancel less than four weeks before the arrival date,
one week of homestay will be charged.
If you cancel less than one week before the arrival date
or there is a no-show, two weeks of homestay will be
charged.
If you booked a homestay for one month or less, you must
give the Student Services Coordinator 2 weeks notice in
writing. If you decide to leave your homestay before
those two weeks, those days will not be refunded. The
first two weeks are non-refundable.
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APPLICATION FORM 2021
2020
There is no refund for missed meals.
If you booked a homestay for more than one month, you
must give the Student Services Coordinator ONE MONTH
notice. If you decide to leave your homestay before that,
the unused days of that month will not be refunded. The
rest of the unused fees will be refunded.
If there is a severe problem with your host family that
requires an immediate transfer, the Student Services
Coordinator will assist in finding a new family at no extra
cost.
As long as there is a valid reason for requesting a change
to a new family, there will be no charge for a new
homestay placement. However, if you decide to change
accommodation for your own reasons, there will be a
charge for the new placement.
All changes, notices or cancellations must be submitted in
writing to the Student Services Coordinator.
Student Residence Cancellation Policy
250 CAD deposit must be paid before arriving to the
residence. 50 CAD will be used for cleaning and the
remaining 200 CAD will be reimbursed to the student at
the end of their stay.
Before Program Start Date
If you cancel four weeks or more before the booking start
date, no cancellation fee will be charged.
If you cancel less than four weeks before the booking start
date, your security deposit will not be refunded.
If you cancel less than one week before the booking start
date or if you do not show up your first month, and your
security deposit will not be refunded.
If you receive a CIC visa refusal or delay on or before the
check-in day, a 30 day written notice is required to obtain
a 100% refund of your rent & damage deposit fees (An
official denial letter from CIC must be submitted to secure
the reimbursement, without the letter policies above
apply).
After Program Start Date
If you wish to cancel your stay at the Student Residence,
you must give the Student Services Coordinator a
minimum 30 days written notice before the original
check-out date is required to process a refund.
ALTERNATIVE ACCOMMODATION
Each service provider has a different policy. Once you
select the alternative accommodation option, you will
receive along with your confirmation letter, the
cancellation policy applicable to that specific
accommodation.
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 APPLICATION FORM 2021

OTHER SERVICES CANCELLATION POLICY acknowledge and understand that:

MEDICAL INSURANCE
Before Program Start Date
If you cancel your program 15 days or more before the
start date, no cancellation fee will be charged. If you cancel
your program 14 days or less before the start date, 100%
of the fees will be charged.
Signing this agreement, I waive any claims that I have or
may have in the future against the School, its employees
and representatives.
The offered activity may involve sports, which can expose
me to risks of accident or injury, due to requirement of
certain level of skills and physical fitness necessarily for
these activities.

After the Program Start date
If you cancel your program the original start date or if you
do not show up, 100% of the fees will be charged.
AIRPORT TRANSFER SERVICE
Before Program Start Date
If you cancel your program 15 days or more before the
start date, no cancellation fee will be charged. If you cancel
your program 14 days or less before the start date, 100%
of the fees will be charged.
BLI must receive your arrival information two weeks before
your program start date at the latest. It is your
responsibility to inform us of any change and modification
in your flight. If you do not arrive within 2 hours of your
scheduled arrival time, the driver will leave, and the pick-
up fee will not be refunded.
I hereby release and hold harmless the School with respect
to any and all injuries, disabilities, claims, loss or damage
that may arise from my participation in activities, whether
caused by active or passive negligence of the releases or
otherwise.
By entering into this agreement I am not relying upon any
oral or written statements made by the School or its
employees or representatives other than as written in this
Waiver.
The laws applicable in the Province of: Quebec shall govern
this Waiver if attending courses offered by BLI (Montreal)
Inc. or BLI (Quebec) Inc. I am agreeing for jurisdiction of
the courts of the Province. If any provision of this Waiver
will be found to be invalid, the remaining terms shall be
enforced.

TIME TO PROCESS A REFUND Student Name:

If you are eligible for a refund under the conditions Signature:
above, you will be reimbursed within the 45 to 60 working
day period following the receipt of a written notice of
Date:
cancellation.
Please note that the registration fee and accommodation IF THE STUDENT IS UNDER 16:

placement fee are non-refundable under any Parent’s name:

circumstance.
Signature:
PHOTOGRAPH, VIDEO, VOICE RECORDING AND MATERIAL
CONSENT, WAIVER, INDEMNITY AND RELEASE FORM
I, undersigned, consent to the use of my name, portrait,
picture, photograph, or any text or material produced by
me, as part of any Bouchereau Lingua International (BLI)
produced material. I understand that this may be made
available online and in printed form. I agree that I shall
have no claim against BLI or against anyone accessing this
content, whether online, in print or by any other means.
I confirm that I have not given anyone the exclusive right
to use my name, portrait, picture, photograph, or text
produced by me.

WAIVER / LIABILITY AND ASSUMPTION OF RISK

In consideration for being permitted to participate in the
after class and weekend activities organized by BLI
(Montreal) Inc. or BLI (Quebec) Inc. I hereby agree,
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