Student Registration Page

Section 1 - Personal Information

*Title:

*First Name (As it appears on your passport):

Do you have a Family/Last Name?

Yes No

*Family/Last Name:

Middle/Second Name:

Preferred Name:

Preferred name is the name you wish to use in Canada. If your preferred name is the same as your first name, please leave preferred name blank.

*Date Of Birth:

*Country of Birth:

*Country of Citizenship:

*Are you a First Generation Student?

Yes No

A First Generation Student is someone whose parent(s)/guardian(s) have NOT attended post-secondary education (i.e. college, university or an apprenticeship program) in Canada or in any other country. In other words, First Generation Students are the first in their family (besides siblings) to attend post-secondary education. First Generation Students can be recent high school graduates, mature students, or someone new to Canada.

Section 2 - Student Contact Information

Note: This is the address that will appear on your letter of acceptance.

*Country:

*Address:

Address Line 2:

*City/State:

Postal/Zip Code:

Country Code

Area Code

Number

Home Phone:

Cell Phone:

Fax:

*Default Phone:

Home Phone Cell Phone Fax

*Student Email:

*Confirm Email:

Section 3 - Program Selection

*EAS/English Language for Academic Studies:

Yes No

First Choice

*Start Date:

*Program:

Second Choice (Optional)

Start Date:

Program:

Third Choice (Optional)

Start Date:

Program:

Student Registration Page

Section 1 - Personal Information

Section 2 - Student Contact Information

Section 3 - Program Selection

First Choice

Second Choice (Optional)

Third Choice (Optional)

Section 4 - Agent Information

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