Application Form

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Personal Information
SurName GivenName
DateofBirth(mm/dd/yy): Gender: Male    
Female
Nationality Native Language
PlaceofBirth    
Telephone Fax
MailAddress
Email

Guardian Information
Father Mother
Guardian    
Telephone Fax
MailAddress
(if different from applicant's)
Email
Name of relative or friend in Canada
Telephone Fax
MailAddress
Email

Education Background
Last Secondary School Attended
Address
Beginning Date Ending Date
Grade Completed  
English language proficiency examination
TOEFL Score Michigan Test
Other (specify)

I wish to start my study at The Great Lakes College of Toronto
Academic Program:  
Grade 10     Grade 11    
Grade 12     Pre-university Courses
English As Second Language (ESL)
Starting Semester: Year
   January    April    June    September    November
 
Signature  
Date