For Important Information On Our Application Process, click here.
If you are in Canada, please click here to apply
   Online Application for Travel Programs (American Students)

STUDENT INFORMATION

First Name
(as on passport)
  Citizenship  
Last Name
(as on passport)
  Phone  
Middle Name
(as on passport)
Cell Phone
Address   Fax
City   E-mail    
Province/State   Date of Birth      
Country   Sex  
Postal Code/Zip   Current Grade  






PROGRAM SELECTION

 




TRIP, DATE AND COURSE SELECTION

 
   


BLYTH INFORMATION

How did you hear about us?
 
Do you have an Individual Education Plan (IEP)?
 




ACADEMIC INFORMATION

Present School (complete name)   City  





PARENT/GUARDIAN INFORMATION (mandatory for students 18 and under)

  PARENT 1 Same as applicant PARENT 2 Same as applicant
Last name Last name
First name First name
Address Address
City City
Province/State Province/State
Country Country
Postal Code/Zip Postal Code/Zip
Home Phone Home Phone
Business Phone Business Phone
Cell Phone Cell Phone
Fax Fax
Email   Email  




LEGAL GUARDIAN INFORMATION

If parents are separated/divorced, which parent is the legal guardian of the applicant?





TRAVEL INFORMATION

 





MEDICAL INSURANCE AND TUITION/CANCELLATION PROTECTION (one of these options must be checked)

More information
 

Note: Non-refundable in case of cancellation. May only be purchased at the time of registration.