New Student Application Form

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All fields must be filled out.

Enter the date:

-- mm/dd/yy

Chose Location:

Mississauga Campus North York Campus  

Select any of the following options that apply:

Full-time Student
Part-time Student

Programs:

Please provide the following contact information:

New Student
First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

Select any of the following options that apply:

Canadian Citizen
Landed Immigrant
Visa Student

Please provide the following contact information:

Mother/Guardian
First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Please provide the following contact information:

Father/Guardian
First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

If parents are separated, indicate with whom the child is living. Provide copy of relevant custody papers.

Emergency Contact:

First Name
Last Name
Relationship
Phone
Home Phone
E-mail

School History:

School Presently Attending
Years Attended
Present Grade
Prerequisites for your study choice
Please list previous schools attended and dates
Professional Degrees Earned (if available)
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone

 

Copyright © 2009 Queen's Collegiate. All rights reserved.
Revised: 08/25/09