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_____________________________
___
Office Use Only
Handling Officer’s name___________________________________ Memo_____________________________