Data Sheet

Personal Information
Gender*
- Female
- Male
- Other
Title
Legal Name*
First Last
As displayed on your health card or passport
Preferred Name
Previous Legal Last Name
Date of Birth*
MM slash DD slash YYYY
First Language*
In order to determine if you are a first generation applicant to post-secondary education, please respond to the question below (voluntary declaration):
Have either of your parents / guardians attended a university or college?*
- No
- Undeclared
- Yes
Marital Status*
Number of Dependants*
Number of Children*
Ages*

Contact Information
Required*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Cell Phone
Email*
Preferred Method of Correspondence*

Citizenship and Residency
Country of Citizenship*
Status in Canada*
- Citizen
- Landed Immigrant
- Student Visa
- Visitor Visa
- Working Visa
- Refugee
Do you consider yourself to be an Aboriginal person, that is, a person related to, or descended from, the original peoples of Canada?*
- Yes
- No
Country of Birth*

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