Student Information FAMILY NAME FIRST NAME MIDDLE NAME DATE OF BIRTH SEX M F RESIDENCY STATUS CANADIAN CITIZEN INTERNATIONAL STUDENT PERMANENT RESIDENT WORK PERMIT OTHER, SPECIFY CURRENT ADDRESS HOME TELEPHONE CELL/BUESINESS TELEPHONE E-MAIL ADDRESS IF YOU ARE AN INTERNATIONAL STUDENT OR HAVE A WORK PERMIT PLEASE PROVIDE THE FOLLOWING: COUNTRY OF CITIZENSHIP PASSPORT NUMBER VISA NUMBER ISSUANCE DATE EXPIRY DATE PLACE OF ISSUE Parents/Guardian Information FATHER'S NAME MOTHER'S NAME BUSINESS TELEPHONE BUSINESS TELEPHONE CELL NUMBER CELL NUMBER HOME TELEPHONE HOME TELEPHONE Emergency Contact Person Allergies Or Medical Conditions NAME HOME TEL RELATIONSHIP TO STUDENT BUSINESS TELL PLEASE PROVIDE DETAILS School Previously Attended Where did you hear about us SCHOOL NAME & ADDRESS Bus Advertising Friends Law Sign Newspaper Internet Search Street Sign Flyer TV Commercial Course Of Study For Which You Are Registering GRADE 9 ENG1D SNC1D MPM1D FSF1D CGC1D AVI1O GRADE 10 ENG2D SNC2D MPM2D FSF2D CHC2D AVI2O CHV2O GRADE 11 ENG3U MCR3U SPH3U SCH3U SBI3U ISC3M AVI3M CLN3U GRADE 12 ENG4U OLC4U EWC4U MHF4U MCV4U MDM4U SPH4U SCH4U SBI4U HHS4M CLN4U CGW4U HZT4U CPW4U AVI4M ISC4M Course Starting Date Fall Semester (Sep.-Jan,) Winter Semester (Feb.-June) Summer Semester (July/August) ESL/ENGLISH ASSESSMENT TEST ESL D ESL E TOEFL IELTS LYGCU LYGDU LKODU RTEP MELAP YELT Submit
