Pular para o conteúdo
Serviços
Housing
Phonebox
Cursos e Imigração
Estudar
Estudar e Trabalhar
Estudar para Imigrar
Summer Camp
Destinos
HiBonjour
Blog
Depoimentos
FAQ
Contato
Menu
Serviços
Housing
Phonebox
Cursos e Imigração
Estudar
Estudar e Trabalhar
Estudar para Imigrar
Summer Camp
Destinos
HiBonjour
Blog
Depoimentos
FAQ
Contato
Health Insurance Enrollment
Please fill the form bellow to enroll your insurance.
"
*
" indica campos obrigatórios
What insurance would you like to enroll?
*
GTA (only for Brazilian students)
Ingle
Allianz Canada
Guard.me
OSHC (Australia insurance for international students)
Ingle options
*
Silver
Gold
Platinum
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
Gender
*
Male
Female
Other
Address
*
City and State
*
Zip Code
*
Country
*
Phone number
*
Email
*
Passport number
*
Do you have an address in Canada?
*
Yes
No
Canada Address
Address
*
City
*
Zip Code
*
Province
*
Emergency Contact
Full Name
*
Phone number
*
Address
*
City/State
*
ZIP Code
Relationship with this emergency contact
*
Insurance Information
Type of plan
*
GTA (only for Brazilian students)
Ingle / Allianz Canada
Guard.me
OSHC ( Australia insurance for International students)
Destination
*
Canada
Australia
Other
Name of the school you are going to study:
Student ID from the school you’ll study (can find this number in your LOA (Letter of Acceptance) )
Amount of your Insurance Cover (If you don't have it, just put the number ZERO)
*
Insurance start date
*
MM barra DD barra YY
Insurance end date
*
MM barra DD barra YY
Will the flight pass through the USA (United States of America) ?
*
How many members of the family will be travel with you?
0
1
2
3
4
5
Family Member 1
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
ID number from your country (Example: CPF in Brazil / Cedula de ciudadania (CC) in Colombia)
*
Same address as main applicant?
*
Yes
No
Address
*
City/State
*
ZIP Code
Country
*
Passport number
*
Phone
*
Email
*
Family Member 2
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
ID number from your country (Example: CPF in Brazil / Cedula de ciudadania (CC) in Colombia)
*
Same address as main applicant?
*
Yes
No
Address
*
City/State
*
ZIP Code
Country
*
Passport number
*
Phone
*
Email
*
Family Member 3
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
ID number from your country (Example: CPF in Brazil / Cedula de ciudadania (CC) in Colombia)
*
Same address as main applicant?
*
Yes
No
Address
*
City/State
*
ZIP Code
Country
*
Passport number
*
Phone
*
Email
*
Family Member 4
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
ID number from your country (Example: CPF in Brazil / Cedula de ciudadania (CC) in Colombia)
*
Same address as main applicant?
*
Yes
No
Address
*
City/State
*
ZIP Code
Country
*
Passport number
*
Phone
*
Email
*
Family Member 5
Full name (Same as on passport)
*
Date of birth
*
MM barra DD barra YY
ID number from your country (Example: CPF in Brazil / Cedula de ciudadania (CC) in Colombia)
*
Same address as main applicant?
*
Yes
No
Address
*
City/State
*
ZIP Code
Country
*
Passport number
*
Phone
*
E-mail
*
Proof of Payment
Please attached the receipt. If you have questions about the payment let us know. When we send the quote, you’ll receive the methods of payments together.
Types of files accepted: jpg, gif, jpeg, pdf, doc, docx. Maximum size of the file: 20MB
Máx. tamanho do arquivo: 128 MB.
Maximum capacity for the file 20MB
