Company First Name Last Name Grade Applied 9 10 11 12 Program Selection OSSD - High School Program Summer Program Night School / Evening Courses Preferred Enrollment Date Semester 1 (Sep-Oct) Semester 2 (Nov-Dec) Semester 3 (Jan-Feb) Semester 4 (Mar-Apr) Semester 5 (May-Jun) Summer School (July-Aug) Date of Birth Gender Male Female Phone Number Email Nationality Native Language Address Status in Canada Citizen Permanent Resident Study Permit Other Education History From edu_hist_from_1 edu_hist_from_2 edu_hist_from_3 edu_hist_from_4 To edu_hist_to_1 edu_hist_to_2 edu_hist_to_3 edu_hist_to_4 School Name edu_hist_school_1 edu_hist_school_2 edu_hist_school_3 edu_hist_school_4 Highest Level Achieved edu_hist_highest_1 edu_hist_highest_2 edu_hist_highest_3 edu_hist_highest_4 All original transcripts or school records from the current year and the last two years must be official and translated into English. Failure to comply may result in return of the application package or delay of the application process. Father First Name Father Last Name Father Date of Birth Father Phone Father Email Mother First Name Mother Last Name Mother Date of Birth Mother Phone Mother Email Custodian Information First Name Last Name Date of Birth Gender Male Female Address Phone Number Email Agent Information (If applicable) Agent Name Company Name Phone Number Email
