1576 Dundas Street West, Mississauga ON L5C 1E5
+1 905-232-1576
[email protected]
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Student Basic Information:
OEN :
Given (First) Name
*
:
Preferred First Name :
Family (Last) Name
*
:
Second Name :
Date of birth
*
:
Country of birth :
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA AND BARBUDA
ARUBA
ARGENTINA
ARMENIA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BERMUDA
BHUTAN
BOLIVIA
BOTSWANA
BOSNIA & HERZEGOVINA
BRAZIL
BELIZE
SOLOMON ISLANDS
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
MYANMAR
BURUNDI
CAMBODIA
CAMEROON
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
SRI LANKA
CHAD
CHANNEL ISLANDS
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, DEMO REP OF THE
COOK ISLANDS
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
BENIN
BOUVET ISLAND
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EL SALVADOR
EQUATORIAL GUINEA
ESTONIA
ETHIOPIA
ERITREA
FAEROE ISLANDS
FALKLAND IS (MALVINAS)
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERR
DJIBOUTI
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
TUVALU
GREECE
KOSOVO
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUYANA
HAITI
HEARD ISL & MCDONALD IS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND, REP OF (EIRE)
ISLE OF MAN
ISRAEL
ITALY
CÔTE D'IVOIRE
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA SOUTH
KOREA NORTH
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA (FYROM)
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FD STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
OMAN
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
PAPUA NEW GUINEA
VANUATU
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
PAKISTAN
OCCUPIED PALESTINIAN TERR
PALAU
PANAMA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
GUINEA-BISSAU
TIMOR-LESTE
PUERTO RICO
QATAR
RÉUNION
ZIMBABWE
ROMANIA
RWANDA
RUSSIAN FEDERATION
ST HELENA
ST KITS AND NEVIS
ST LUCIA
ST PIERRE AND MIQUELON
ST VINCENT AND THE GRENADINES
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SLOVAKIA
SLOVENIA
SINGAPORE
SOMALIA
SOUTH AFRICA
S GEORGIA & S SANDWICH ISLANDS
NAMIBIA
SPAIN
SUDAN
SURINAME
SVALBARD AND JAN MAYEN ISLAND
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAJIKISTAN
TAIWAN
TANZANIA, UNITED REP OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
UNITED ARAB EMIRATES
TUNISIA
TURKEY
TURKS AND CAICOS ISLANDS
TURKMENISTAN
UGANDA
UKRAINE
EGYPT
UNITED KINGDOM
UZBEKISTAN
ENGLAND
NORTHERN IRELAND
SCOTLAND
WALES
UNITED STATES
US MINOR OUTLYING ISLDS
BURKINA FASO
URUGUAY
VATICAN CITY STATE
VENEZUELA
VIET NAM
BRITISH VIRGIN ISLANDS
VIRGIN ISLANDS (U.S.A.)
ST MARTIN
WALLIS AND FUTUNA
WESTERN SAHARA
SAMOA
ST BARTHELEMY
YEMEN
SERBIA & MONTENEGRO
MONTENEGRO
ZAMBIA
SERBIA
STATELESS
NOT REPORTED
CANADA
Gender
*
:
Male
Female
First Language :
English
Mandarin
Cantonese
Korean
Vietnamese
Thai
Pilipino
Russian
Arabic
French
Malay
Urdu
Pashto
Persian (Farsi)
Farsi
Japanese
Tamil
Punjabi
Hindi
Other
Serbian
Somali
Romanian
Swedish
Singhalese
Bengali
Gujarati
Resident Status :
Canadian Citizen
Permanent Resident
Refugee Status
Study Permit/Visitor Record
Other Status
Not Applicable
Attendance Type :
FT
PT
Grade
*
:
12
11
10
9
Home school
*
:
School Admission From :
Referral :
Student Contact Information:
Street address
*
:
Town/City :
Province :
Country :
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA AND BARBUDA
ARUBA
ARGENTINA
ARMENIA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BERMUDA
BHUTAN
BOLIVIA
BOTSWANA
BOSNIA & HERZEGOVINA
BRAZIL
BELIZE
SOLOMON ISLANDS
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
MYANMAR
BURUNDI
CAMBODIA
CAMEROON
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
SRI LANKA
CHAD
CHANNEL ISLANDS
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, DEMO REP OF THE
COOK ISLANDS
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
BENIN
BOUVET ISLAND
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EL SALVADOR
EQUATORIAL GUINEA
ESTONIA
ETHIOPIA
ERITREA
FAEROE ISLANDS
FALKLAND IS (MALVINAS)
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERR
DJIBOUTI
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
TUVALU
GREECE
KOSOVO
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUYANA
HAITI
HEARD ISL & MCDONALD IS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND, REP OF (EIRE)
ISLE OF MAN
ISRAEL
ITALY
CÔTE D'IVOIRE
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA SOUTH
KOREA NORTH
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA (FYROM)
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FD STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
OMAN
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
PAPUA NEW GUINEA
VANUATU
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
PAKISTAN
OCCUPIED PALESTINIAN TERR
PALAU
PANAMA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
GUINEA-BISSAU
TIMOR-LESTE
PUERTO RICO
QATAR
RÉUNION
ZIMBABWE
ROMANIA
RWANDA
RUSSIAN FEDERATION
ST HELENA
ST KITS AND NEVIS
ST LUCIA
ST PIERRE AND MIQUELON
ST VINCENT AND THE GRENADINES
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SLOVAKIA
SLOVENIA
SINGAPORE
SOMALIA
SOUTH AFRICA
S GEORGIA & S SANDWICH ISLANDS
NAMIBIA
SPAIN
SUDAN
SURINAME
SVALBARD AND JAN MAYEN ISLAND
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAJIKISTAN
TAIWAN
TANZANIA, UNITED REP OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
UNITED ARAB EMIRATES
TUNISIA
TURKEY
TURKS AND CAICOS ISLANDS
TURKMENISTAN
UGANDA
UKRAINE
EGYPT
UNITED KINGDOM
UZBEKISTAN
ENGLAND
NORTHERN IRELAND
SCOTLAND
WALES
UNITED STATES
US MINOR OUTLYING ISLDS
BURKINA FASO
URUGUAY
VATICAN CITY STATE
VENEZUELA
VIET NAM
BRITISH VIRGIN ISLANDS
VIRGIN ISLANDS (U.S.A.)
ST MARTIN
WALLIS AND FUTUNA
WESTERN SAHARA
SAMOA
ST BARTHELEMY
YEMEN
SERBIA & MONTENEGRO
MONTENEGRO
ZAMBIA
SERBIA
STATELESS
NOT REPORTED
CANADA
Zip Code :
E-Mail Address
*
:
Phone :
Parent Contact Information:
First Name
*
:
Last Name
*
:
E-Mail Address
*
:
Phone :
Full Address :
Relationship :
Guidance information different from parent information?
Yes
No
Guidance Contact Information:
First Name :
Last Name :
E-Mail Address :
Phone :
Full Address :
Relationship :
Emergency Contact Information:
First Name :
Last Name :
E-Mail Address :
Phone :
Full Address :
Relationship :
Note :
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