Contact Information
First Name*
First
Last Name*
Last
Preferred Name
First
Email*
Phone*
Date of Birth (mm/dd/yyyy)*
Gender (required for contract)*
As requested by the Private Training Institutions Branch of British Columbia, we are obligated to ask for gender.
- Female
- Male
- Prefer Not to Say
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How did you hear about us?
- Word-of-mouth (friend/family/colleague)
- Social Media
- Organic search (Google)
- Newsletter
Emergency Contact
In the event of an emergency or if we are unable to reach you, we will contact this person for urgent matters.
Emergency Contact Name*
Relationship*
Phone*
Email*

Application
Intake:*
Please note these times are in PST.
- May 2023 - Thursday May 4 - July 20 (4:30 - 7:30PM PST)
Deposit:*
Once you submit this application form, please note that there is a $200 non-refundable deposit required to reserve your spot which will be deducted from your first payment. If you are unsure about the program you want, or if you need more clarification, please contact before filling out this application form.
- Yes, I understand
Invoicing*
Please choose your payment plan. All prices are in Canadian dollars. Please note that we do not provide student loans. Amounts stated below includes the $200 deposit.
- TAMPs: Yes, please invoice me for the full amount ($2985).
- TAMPs: Yes, please invoice me in 3 installments ($995 per month).
Student Loans:
As we cannot provide student loans, would you like more information about payment plan options?
- Yes
- No

CiiAT | Canadian International Institute of Art Therapy

Application Form TAMPS