1576 Dundas Street West, Mississauga ON L5C 1E5
+1 905-232-1576
[email protected]
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Form
Student Basic Information:
OEN :
Given (First) Name
*
:
Preferred First Name :
Family (Last) Name
*
:
Second Name :
Date of birth
*
:
Country of birth :
CANADA
CHINA
HONG KONG
VIET NAM
TAIWAN
INDIA
KOREA SOUTH
PHILIPPINES
SINGAPORE
MEXICO
SRI LANKA
CHILE
BRAZIL
IRAQ
IRAN
JORDAN
QATAR
PAKISTAN
INDONESIA
KUWAIT
NOT REPORTED
ROMANIA
GERMANY
CHAD
EGYPT
BANGLADESH
PANAMA
RUSSIAN FEDERATION
SAUDI ARABIA
SERBIA
SUDAN
COSTA RICA
AFGHANISTAN
OMAN
ISRAEL
FRANCE
JAPAN
UNITED STATES
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 :
CANADA
CHINA
HONG KONG
VIET NAM
TAIWAN
INDIA
KOREA SOUTH
PHILIPPINES
SINGAPORE
MEXICO
SRI LANKA
CHILE
BRAZIL
IRAQ
IRAN
JORDAN
QATAR
PAKISTAN
INDONESIA
KUWAIT
NOT REPORTED
ROMANIA
GERMANY
CHAD
EGYPT
BANGLADESH
PANAMA
RUSSIAN FEDERATION
SAUDI ARABIA
SERBIA
SUDAN
COSTA RICA
AFGHANISTAN
OMAN
ISRAEL
FRANCE
JAPAN
UNITED STATES
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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