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Title
Cheif
Mr.
Mrs.
Ms.
Dr.
Gender
Male
Female
Name
*
First
Last
Name
*
First
Middle
Last
Citizenship
*
Date of Birth
*
Marital Status
*
Married
Single
Travelling Alone?
*
Yes
No
First Language
*
Other Languages
STUDENT PERMANENT CONTACT INFORMATION
Address
*
Address Line 1
City
State / Province / Region
Telephone - Home
*
Telephone - Home
Email
*
Preferred Mode of Contact
*
Phone
E-mail
Passport Number
*
Date of Issue
*
Date of Expiry
*
Country of Birth
*
SPONSOR DETAILS (COMPULSORY)
Full Name
*
Affiliation (eg. Parent)
*
EMERGENCY CONTACT IN YOUR HOME COUNTRY
Name
*
Relationship to Applicant
*
Emergency Contact Address
*
Emergency Contact Phone Contact
*
Emergency Contact Cell Number
Emergency Contact Work Number
Choose School Type
General (any school)
Affiliated School Only
(School type refers to you selecting “Affiliated School” OR “General” which means any school any where in Canada)
Do you have a Provincial Exam Number (P.E.N)?
*
Yes
No
(If ‘Yes’ please state your P.E.N number)
Province
*
Number
*
PROGRAM CHOICE
Undergraduate Degree:
*
Yes
No
(Please, fill three different programs of interest below according to priority)
First Choice
*
Second Choice
*
Third Choice
*
Graduate Degree:
*
Yes
No
GPA Score
*
IELTS Score
GRE Score
Program
MBA: GMAT Score
LWA: LSAT Score
Graduate Diploma
*
Yes
No
Graduate Certificate
*
Yes
No
If yes: Program Name
If yes: Certificate Name
Undergraduate Diploma
*
Yes
No
Undergraduate Certificate
*
Yes
No
If yes: Program Name
*
If yes: Certificate Name
*
University ESLI (English as a second Language International):
*
Yes
No
If ‘Yes’ please choose ESLI program
ESLI only
ESLI/university program (Semester based)
Include University Program
ESLI Pre-Master’s Program?
*
Yes
No
College ESLI Program:
*
Yes
No
Bridge Program:
*
Yes
No
(High School/University combined program):
College diploma Program:
*
Yes
No
When do you want to begin your program?
*
September (Fall)
January (Winter)
May (Summer)
Year:
*
Senior High School Attended: (State Month, Day, and Year as requested below)(Please, compulsory)
Name of High School
*
From(dd/mm/yyyy)
*
To(dd/mm/yyyy)
*
Grade Completed
*
All Universities or Colleges Attended:
Name of High School Colleges 1st:
From(dd/mm/yyyy)
To(dd/mm/yyyy)
Degrees/Diplomas Granted
Name of High School Colleges 2nd:
From(dd/mm/yyyy)
To(dd/mm/yyyy)
Degrees/Diplomas Granted
What did you do last year:
*
Secondary School
College
University
Labour force
Where did you live last year:
*
British Columbia?
Another Province?
Other:
Other:
Where do you want to go for your Study
*
Canada
USA
UK
Germany
Italy
Austraila
Valid documents & School credentials for school search attached:
*
Yes
No
English Proficiency Test (eg. TOEFL, IELTS):
*
Yes
No
Score:
*
Comment
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