For HEU members who have completed classes with MOSAIC only Please complete the form below to request reimbursement for IELTS, CELPIP, or CLBPT language tests. Name as written on official identification Language test (select one) IELTS CELPIP CLBPT Name of testing centre Test location (city) Date of test Receipt upload Please upload your receipt showing: Test name (IELTS, CELPIP, CLBPT)Name of testing center Your name Payment confirmation One file only.4 GB limit.Allowed types: pdf, doc, docx, gif, jpg, png, bmp, pict, txt, rtf, odf. Certificate upload Please upload your course completion certificate from MOSAIC One file only.4 GB limit.Allowed types: pdf, doc, docx, gif, jpg, png, bmp, pict, txt, rtf, odf. email address Please fill out your mailing address. It must be in Canada. Mailing address Street address Apartment or Unit City/Town Province - Select -British ColumbiaAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Postal Code Country - Select -Canada I confirm that I am an HEU member who has taken classes with MOSAIC and that the information provided is accurate. What happens nextAfter you submit:We will review your application and receipt for completeness.If we need anything, we’ll contact you by email.Once approved, reimbursement will be issued by a cheque to your mailing address. (It might take up to 12 weeks to receive your reimbursement)
