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The University of British Columbia

Department of Civil Engineering


2002 – 6250 Applied Science Lane, Vancouver – BC, V6T 1Z4
Tel: (604) 822.2637  Fax: (604) 822.6901
Email: info@civil.ubc.ca  Website: www.civil.ubc.ca

VISITING UNDERGRADUATE RESEARCH (VURS) APPLICATION FORM


SPONSORING FACULTY MEMBER

Name:

Date of Visit: Start: (yy/mm/dd) End: (yy/mm/dd)

PERSONAL INFORMATION

Last Name First/Given Name Middle Name

MAILING ADDRESS

Apt No./Street Address

City Prov/State Country

Telephone (country & area code)) Alternate Telephone No. Email

 Male Date of Birth Country of Birth

 Female Languages Spoken Canadian SIN # (if applicable)

APPLICATION FEE 2007 (NON-REFUNDABLE)


 $60 * (Canadian and Permanent Resident applicants)  $100 * (International Students)
* Prices are subject to change

 American Express
Name
 MasterCard Credit Card No. Exp. Date
 Visa Signature

Payment may be made in Canadian or US funds. Cheques and bank drafts must be drawn on a Canadian or US banknote. Only International money
orders are acceptable. Payments should be made payable to The University of British Columbia. Please note: applications cannot be processed
until full payment is received.

CITIZENSHIP
Permanent Resident who are not Canadian Citizens must submit proof of
 Citizen  Permanent Resident/Landed Immigrant immigration with application

Country  Study Permit


Date of Arrival  Minister’s Permit
 Other (specify)

CURRENT UNIVERSITY/INSTITUTION
Name Prov/State/Country Grade/Level From To

ENGLISH PROFICIENCY TEST(S): PLEASE INDICATE WHAT, IF ANY TESTS YOU HAVE TAKEN.

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