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Canadian College Online Registration
Personal Information
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Last(Family) Name*:
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Given(First) Name(s)*:
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Gender*:
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Female
Male
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Date of Birth (Year/Month/Day)*:
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Country of Residence*:
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Nationality*:
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Passport Number (if applicable):
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Permenant Address In Home Country
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Street Address*:
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Apt#*:
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City*:
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State/Province*:
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Country*:
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Postal Code* :
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E-mail*: compulsory
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E-mail2*:
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(Please type again, do not copy & paste)
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Alternative E-mail:
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Home Telephone Number*:
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Fax:
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Mailing Address (If Different From Above)
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Street Address:
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Apt#:
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City:
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State/Province:
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Country:
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Postal Code:
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E-mail:
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Home Telephone Number:
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Fax:
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EMERGENCY CONTACT
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Last(Family) Name*:
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Given(First) Name(s)*:
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Relationship:
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Language Spoken:
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Street Address*:
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Apt#*:
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City*:
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State/Province*:
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Country*:
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Postal Code*:
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E-mail*:
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Home Telephone Number*:
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Alternative Telephone Number:
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How did you hear about us?*:
Agent
Name of Agent
City
(If applying through an Agent)
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Academic Information
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Are you or will you be a graduate by the first day of college (you are applying for) ?*:
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Yes
No
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Secondary School Graduate
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Yes
No
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College Graduate
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Yes
No
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University Graduate
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Secondary School Transcript
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Attached
To Follow
N/A
Please email to <filmocomm@yahoo.com>
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College Transcript
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Attached
To Follow
N/A
Please email to <filmocomm@yahoo.com>
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University Transcript
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Attached
To Follow
N/A
Please email to <filmocomm@yahoo.com>
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TOEFT Score*
IELTS Score*
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Attached
To Follow
N/A
Please email to <filmocomm@yahoo.com>
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Other Transcripts
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Attached
To Follow
N/A
Please email to <filmocomm@yahoo.com>
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Program Selection
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POST-SECONDARY PROGRAM - DIPLOMA/CERTIFICATE
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Program Priority*:
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1st choice - Program Title
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start date(year/month)
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2nd choice - Program Title
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start date(year/month)
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Intensive English Program *:
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4 weeks
8 weeks
8 weeks
12 weeks
16 weeks
24 weeks
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Start Date (Year/Month)
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Do you need Homestay Service?
Yes
No
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Do you need Airport Pick-up?
Yes
No
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Payment Information
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Payment can be made by Bank Draft in favour of the Canadian College
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DECLARATION
I certify that all the information provided in this form is true and complete. I understand that false or incomplete information
submitted in support of my application may invalidate my application and result in the withdrawal by the college of a seat at any time during my enrollment
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Applicant's Name(please print)*:
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Date (Year/Month/Day)*:
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Field(s) with * should be completed to submit the form.
Passport page with photo
Recent p/p size photo 400 x 514 pixel
1st Highest Edu Cert
Marks Result Transcript
2nd Highest Edu Cert
Marks Result Transcript
Work Exp. Cert / Testimonial (1)
Work Exp. Cert / Testimonial (2)
Parent's marriage certificate
Bank Statement
Others
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