Initial Application to Access Your Educational Needs

---

 

Application Information

 

Last Name            First Name                   Initial

Birthday (mm/dd/yyyy):             Gender            Marital Status:

Indicate all other names used on official records

Address (All correspondence will be sent to the mailing address)

Address    City   State

Home Phone       Email Address       GSM/Mobile

Fax number           Have you ever been abroad?  Yes  No

If no, which Country?  

Were you ever deported from any country?  Yes   Which Country?

Give details 

In which country do you intend to study?  Canada    USA    Others

What course(s) do you intend to study?  You may pick up three courses 

What year do you intend to start your course(s)? (We shall advice on  which semester/term is best for you)   

list all your academic qualifications

Choose your desired service below:

1. Counseling on study abroad only (Applicable Fees)

2. Full service Package (Applicable Fees)

I certify that the information provided on this application is true and complete to the best of my knowledge and understand that omission or misrepresentation of facts or failure to furnish information to the Global Educational Consultancy, Inc. may hinder the company in providing me with prompt and adequate service.