PLEASE FILL OUT THE FORM BELOW TO VIEW OUR BROCHURE ONLINE I am a:* Parent / Guardian Student Salutation* --None--Mr.Ms.Mrs.Dr.Prof.MissRev. Parent Name:* Parent Email* Parent Phone* Street: City: Postal Code* State/Province: Country: Student Name:* Grade:* --None--56789101112 Date Of Birth:* Student Email:* Student Phone:* Street: City: Postal Code:* State/Province: Country: Are youIs your child a previous Blyth Academy student?:* --None--YesNo Parent Name:* Parent Email:* Please fill all the required fields! I am interested in learning about the following Programs:* International Summers & Comm. Service Blyth Academy Ontario Campuses Blyth Academy Online Blyth Academy Global High School Blyth Academy Florence Blyth Academy Qatar Blyth-Academy Templeton Please fill all the required fields! Please select the program type(s) you are interested in:* International Summers (Academic Program) Community Service Summer (Volunteer Program) March Break (Volunteer & Academic Programs) Please fill all the required fields! Please select the March Break Program(s) you are interested in:* Costa Rica (Volunteer) Nicaragua (Volunteer) Peru (Volunteer) Cozumel (Academic) Please fill all the required fields! Please select the Community Service program(s) you are interested in:* Costa Rica (2 weeks) Nicaragua (2 weeks) Costa Rica & Nicaragua (4 weeks) Please fill all the required fields! Please select the International Summers program(s) you are interested in:* Costa Rica (9-10) France (9-10) England, Scotland and Ireland (9-10) Newfoundland (9-10) Iceland (9-10) 2-Course Central America (11-12) Amazon and Galapagos (11-12) Asia (11-12) Australia, New Zealand and Fiji (11-12) Costa Rica (11-12) Cozumel (11-12) England, Ireland and Rome (11-12) France (11-12) Grand Tour Central Europe (11-12) Grand Tour Eastern Europe (11-12) Grand Tour Western Europe (11-12) Hawaii (11-12) Iceland (11-12) Italy (11-12) Rome and The Greek Islands (11-12) Nicaragua (11-12) Peru (11-12) Spain (11-12) Please fill all the required fields! Please select which Global High School term(s) you are interested in:* Full Academic Year Semester 1 Semester 2 Term 1 only Term 2 only Term 3 only Term 4 only Please fill all the required fields! Please make a student selection:* Domestic (Canadian) Student International Student Please fill all the required fields! Please select which Blyth Academy program(s) you are interested in:* Full-time School Part-time School Night & Saturday School Private, Semi-Private & Repeat Courses Summer School Select the Campus(es) You are Interested In: Yorkville Lawrence Park Thornhill Downsview Park Whitby Burlington Waterloo Ottawa Mississauga Blyth@CIHA London Please fill all the required fields! Please select which full-time school term(s) / program(s) you would like to participate in.* Full Academic Year Sports Program Semester 1 Semester 2 Term 1 only Term 2 only Term 3 only Term 4 only Please select which part-time semester(s) you are interested in:* Part-time Fall Part-time Winter How did you hear about Blyth Academy?: Search Engine (eg Google)Social Media (Facebook, Twitter, Instagram.)EmailOnlineBrochures and Printed MaterialRadioFriend or ColleagueStudent RepGuidance DepartmentOutdoor or Transit AdNewspaper AdMagazine AdOther Student Rep Name:* Guidance Department School Name:* Search Engines - Web Search:* GoogleYahooBingAskAOLBaiduOther Social Media (Facebook, Twitter, Instagram):* FacebookTwitterInstagram Email campaign:* Email campaign from Blyth AcademyEmail campaign from other company Brochures and Printed Material:* BrochurePostcardPosterMailingOther Please tell us your friend or colleague's name.* Web SearchOnline AdBlyth Summers Web PageBlyth Academy Web PageOnline article BrochurePostcardPosterMailingFaxOther Online Ad Website Name:* 680NewsVirgin RadioClassical FM980AM1310AMOther --None--BillboardBus AdvertisingGO TrainTTC AdvertisingRink BoardOther --None--Globe and MailToronto StarLocal NewspaperSNAPOther --None--Post City MagazinePorter MagazineToronto LifeOSCAThe DiplomatOther --None--ParentStudentPrincipalPartnerOther --None--ActiveNot ActiveLead --None--Academy OpportunityTravel Opportunity Receive Blyth Academy updates? Yes, I would like to receive occasional updates by email from Blyth Academy inclusive of exclusive offers & news. Please add me to the electronic communications list. By clicking “Submit”, I give permission for Blyth Academy to contact me. I understand I can unsubscribe at any time.
