United's Catalyst Booking Form

Session

Session 1 (July 10-21, 2023)

Session 2 (July 24-August 4, 2023)

Session 3 (August 14-25, 2023)

Surname

Given Name

Preferred Name (optional)

Date of Birth

Gender

HealthCard Number (optional)

Student Cell Phone Number

Student Email Address

Dietary Restrictions/Allergies or Accessibility Needs

Home Address

Address

Address 2

City/Town

State/Province

Postal Code/ZIP(+4) code

Country

Name of Parents/Guardians

Parent or Guardian Email Address

Parent or Guardian Phone Number

Emergency Contact Information (if different than Parent/Guardian)

Expected Arrival Date to United's Residence

Expected Departure Date From United's Residence

Select your room style

Single room (limited availability)

Double Room