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Application Form

                         

 

 

APPLICATION FOR ADMISSION(PDF download

 

 

*Personal Information

Family Name______________________      Given Name_______________________      Preferred Name______________________

Date of Birth: D/M/Y _________/_________/_________   Gender: Male Female    Place of Birth__________________      Citizenship____________  Native Language__________   Date of Entry in Canada: D/M/Y __________/__________/__________ 

Current Address ___________________________________________________________________________________________

Telephone (______)___________________     Fax_________________________      E-mail___________________________

Information of Parents/Guardian(s) -If Under 18

Mother_________________________      Tel(______)_________________________    Email____________________________________

Father_________________________       Tel(______)__________________________    Email____________________________________

Address_______________________________________________________________________________________________________

Guardian________________________     Tel(______)__________________________    Email____________________________________

*Emergency Contact

Name______________________  Tel(_____)________________  Email_______________________  Relationship______________________

                                               ____

*Education Background

School Previously Attended__________________________________________________________________________________________________

Beginning Date___________________  Ending Date_________________  Grade/Degree__________________  Note_______________

                                          ____    

*I wish to begin study at The Duncan Academy

Academic Program Sept_____  Nov_____  Jan_____  Mar_____  May_____  July_____  August_____, Year____________

Courses enrolled___________________________________________________________________________________________

                                       ____       

I acknowledge that I have read the prospectus for The Duncan Academy, the condition of acceptance, and the fees and refund policies. I hereby state my acceptance of those conditions, policies and the information given in this application is complete and correct to the best of my knowledge.

Signature of Parent or Guardian (if Applicant is under 18 years of age)_________________________________________________

*Signature of Applicant_____________________________________        *Date_____________________________

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Office Use Only

Handling Officer’s name___________________________________       Memo_____________________________