william academy application form
TRANSCRIPT
Tel: (416)491-6888 WhatsApp: +1437 992 2888 WeChat: WilliamAcademy
E-mail: [email protected] www.WilliamAcademy.ca
William Academy Application Form
Student Information and Family Information
Legal Name (FAMILY) (Given)
Gender Nationality
Uniform Size XS S M
L XL
Date of Birth (YYYY/MM/DD)
WeChat/ WhatsApp/Viber
Phone Number Grade
Completed School
Attended
Email Address
Father’s name
(FAMILY) (Given) Phone number
WhatsApp/ Wechat /Viber
Date of Birth (YYYY/MM/DD)
Email Address
Mother’s name (FAMILY)(Given) Phone number
WhatsApp/ Wechat/Viber
Date of Birth
(YYYY/MM/DD) Email Address
Home Country Address
(Address) (Country) (Postal Code)
Other Information If you have a medical history, please fill up Schedule A at page 2. If you have a previous visa refusal by US or Canada, please fill up Schedule B at page 2.
School Registration and Agent Information
School term September November January March July August Other _________ Enrolment Year: _____________
IELTS/TOEFL Score: Have you study outside your home country?
Grade applying for Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 University Prep
How did you hear about William Academy?
Education Fair Website Other: _____________________________________________ Name ______________________________ Tel ____________________ Email ________________________
Future Field of Study Engineering Computer Business/Commerce Social Science Art Others
Student Visa Service Provider Name ____________________________________ Tel _________________________ Email __________________________
Need school to provide meals and Accommodation?
Yes No Cobourg: On-campus shared room.
Custodian Information (If Applicable) School provide Student Agent provide Name of Custodian
(FAMILY) (Given) Date of Birth
(YYYY/MM/DD))
Gender
Status in Canada Canadian Citizen Permanent Resident Mobile Phone
Home Address (Address) (Province) (Postal Code)
Signature of Applicant/Parents __________________ Date _____________________
Schedule A: Medical History 1. List any medical conditions the school should be aware of:
2. List any medications you are taking that the school should be aware of:
3. Do you require assistance taking your medication?
4. List any allergies you have:
5. Do you carry an epipen or inhaler? If yes, which do you carry?
Schedule B: Visa Application History 1. Date of visa application submission_________________
Visa was: approved denied approved for extension
If denied, state reason for refusal: ___________________________________________
2. Date of visa application submission_________________
Visa was: approved denied approved for extension
If denied, state reason for refusal:___________________________________________
3. Date of visa application submission_________________
Visa was: approved denied approved for extension
If denied, state reason for refusal: ___________________________________________
Tel: (416)491-6888 WhatsApp: +1437 992 2888 WeChat: WilliamAcademyE-mail: [email protected] www.WilliamAcademy.ca
Please include the followings with your application:
a) Photocopy
of
passport
profile
page
b) Photocopies
of
most
recent
academic
records
start
from
grade
9 with
English
Translation
c) IELTS
report
(if
applicable)