Register Form - IH Whistler

Please complete in English only.
If you have already completed the student registration, you may go directly to the Housing registration section (below) Please make sure you fill in your Name below so we may match the records.
Fields marked by "*" are mandatory

Student Information

First Name*: Click in the textbox to the left to start.
Last Name*:
Nationality*:
Date of Birth:

Address:
Phone:
Fax:
Emergency Contact(Name,Phone number) :
Email address*:

Program Information

Course:
Course Start Date:
Course End Date:

Accommodation Details

Type of Accomodation Requested:
Do you smoke? Yes No
Do you drink alcohol? Yes No
Do you like children? Yes No
Do you like dogs? Yes No
Do you like cats? Yes No
Hobbies and Interests:
Do you have any medical problems or conditions?
Do you have allergies?
Date of first day of homestay:
Last day of homestay:

Do you need airport pick-up? Yes No
Enter your arrival time and flight information:

Would you like to purchase medical insurance from IH? Yes No
Start of Medical Coverage:
Last day of Medical Coverage:

Do you have any Questions?