KISS French Application

Name(Required)

First Last

Date of Birth(Required)

Passport Number

Gender(Required)

Male

Female

Chosen Name

First Last

Primary Language(Required)

Other Primary Language

Enter other primary language

Nationality(Required)

Email Address(Required)

Whatsapp Number(Required)

Emergency Contact

First Name Last Name

Emergency Contact Phone

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country

Are you currently in Canada?(Required)

Yes

Are you planning on attending a university or college in Canada?

Yes

Placement Test Date

Please enter the date you completed your placement test

ILAC KISS French Online Application