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COLUMBIA INTERNATIONAL COLLEGE OF CANADA |
Applicant Information申请人资料
Family Name姓氏:
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Given Name名字:________________________________
Address住址: __________________________________
City市:
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Province 省:
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Country 国家:
__________________________
Postal Code 邮政编号: ______________________
Home Phone住宅电话: ____________________
Cell
Phone手机号码: ________________________
Email 电邮地址:_______________________________________________
Date of Birth出生日期 (Day日/Month月/Year 年):
_____________________
Age年龄:
__________________________________
Country of Birth出生地:
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Gender 性别: Male男 Female女
Nationality国籍:
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Country of Residence 居住国家:
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Passport Issued by 护照签发地:
____________________________
Parents / Guardian Information父母 / 监护人资料
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qFather父亲 qGuardian监护人 |
q Mother母亲q Guardian监护人 |
Applicant living with 申请人居住状况: |
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Name姓名: |
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q Both Parents与父母同住 |
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Date of Birth出生日期: |
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q Father Only与父亲同住 |
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Home Address住址:
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q Mother Only与母亲同住 |
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qGuardian Only与监护人同住 |
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City市: |
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Gold Level Program金章课余项目:
Students 15 years old and under, after-school Counsellor and Activity Supervisions including weekend are compulsory (Fees required)
学生年满15岁或以下, 下课后及周未时间, 必须参与由导师组织的一切活动.
Parents may request the same service for students 16 years of age 学生年满16岁时, 父母亦可要求其子女参与此计划:
qNo否 qYes是 |
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Province省: |
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Country国家 / Postal Code邮政编号: |
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Company Name公司名字: |
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Occupation职业: |
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Work Phone公司电话号码: |
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Work Fax公司传真号码: |
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Email电邮: (required如需要) |
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Home Phone住宅电话号码: |
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Home Fax住宅传真号码: |
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Cell Phone手机号码: |
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Applicant’s Educational Background申请人学历背景
Last Secondary School Attended最后就读之中学名称:
_____________________________________________________________
Address of School学校地址:
__________________________________________________________
Beginning Date就读开始时间:
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Ending Date完成时间:
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Form/ Sec/ Grade Completed修毕之级别:______________________
Certificate or Diploma Obtained获得之证书或文凭 (if any如适用): _____________________________
English Language Proficiency Examination英文测验成绩 (if any如适用):
TOEFL托福: ______
Michigan Test密芝根英文测验: _____
Other其它 (specify请列明):_____
I wish to begin my studies at Columbia International College本人希望在哥伦比亚国际学院报读以下课程
Level程度: q Grade 7班 q Grade 8班 q Grade 9班 q Grade 10班 q Grade 11班 q Grade 12班 / Pre-U大学预科班
Start开始时间: qAugust 8月 q October 10月 q January 1月 q March 3月 q May 5月 qJuly 7月 Year 年份: ________________
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Future Field of Study未来进修计划 q University degree大学学位 qCollege degree学院学位 q Other其它 |
Pre-U courses Required必修的预科课程 |
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q Engineering工程 q Genetic / Biology生物学 q Pharmacy (U.K.)药剂 ( 英国 ) q Computer计算机 q Other Sciences其它科学 |
English英文, 2科Math数学, 2科Sciences科学 |
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q Business / Commerce商科 q Other其它 |
English英文, 1 或 2科Math数学 |
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q Social Science社会科学 q Other 其它 |
English英文, 1 科Math数学 |
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q Humanities人文学科 q Other其它 |
English英文 |
Date日期:
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Signed申请人签名:_______________________
Signature of Parent of Guardian 父母或监护人签名 (if applicant is under 18 years of age如申请人未满18岁 ): ____________________________________________________