APPLICATION FOR ADMISSION File number RESERVED FOR THE ADMINISTRATION Letters Numbers CAMPUS PERMANENT CODE Montreal Vancouver IDENTIFICATION OF THE CANDIDATE Family name at birth Social Insurance Number Given name Date of birthYear / Month / Day Sex Other Given name PERMANENT ADDRESS Number Street / P.O. Box Apartment City / town Province/State Postal code Country Residence telephone Office telephone Ext. Email @ MOTHER TONGUE DO YOU PREFER TO TAKE THE COURSE IN: English Other French 1 French 2 3 1 2 English (Montreal PLACE OF BIRTH COUNTRY OF CITIZENSHIP STATUS IN CANADA Campus Only) 1 Canadian 23Canadian Canadian Native 4 Inuit 5 Landed 6 Student 7 Visitor 8 Other citizen (Quebec) (Outside Quebec) Person immigrant visa Specify Father’s last name (even if deceased) Father’s first name (even if deceased) Mother’s maiden name (even if deceased) Mother’s first name (even if deceased) SPACE BELOW RESERVED FOR MINORS ONLY (UNDER THE AGE OF 18 YEARS OF AGE) Same as above or Legal Guardian’s name Guardian’s given name Guardian’s address: Same or Residence telephone Office telephone Ext. Fax Do you have someone in Canada who will be taking care of your application? No Yes If yes, complete the following Last name First name Number Street Apartment City / town Province Country Postal Code Email Residence telephone Office telephone Ext. Fax FORMER STUDIES High School Level High School Diploma 1 Yes 2 No Diploma to be completed Month Year Name of the High School Name of the School Commission Collegial Level Diploma obtained 1 Yes 2 No Diploma to be completed Month Year Name of the College Last semester If many, indicate the last one 1 Yes 2 No University Level Name of the University Last semester CHOICE OF PROGRAM Start date End date Program Title PAYMENT DETAILS VANCOUVER CAMPUS ONLY TYPE OF PAYMENT: Total Tuition Fee $ Cash Check Bank transfer Registration Fee $ Visa Mastercard Total Amount (1) + (2) $ CREDIT CARD: Initial Payment $ Balance Due (3) - (4) $ Number: Date of issue: Expiry date: PAYMENT DETAILS MONTREAL CAMPUS CREDIT CARD: Visa Mastercard TYPE OF PAYMENT: Cash Check Bank transfer Number Date of issue Expiry date How did you hear about our school? Friend Canadian Education Center Agent Other I hereby declare that all the information I have provided is correct. I authorized the college to verify the documents submitted with this application form and authorize the Minist re de l’ ducation to transmit my grades in order to verify my educational background. Date Signature of candidate Signature of Parent or Legal Guardian (for minor candidates) DOCUMENTS REQUIRED WITH APPLICATION: SEE REVERSE SIDE RESERVED FOR THE ADMINISTRATION Duration 3 years 2 years 1 year Cheque Cash Amount Received by White copy: Admission Yellow copy: Financial Services/Data Processing Services Green copy: Student DIRECTIONS A. Carefully complete the opposite side of this form in its entirety. B. Read carefully REQUIRED DOCUMENTS (below) and attach to your application the required pertinent documents. DOCUMENTS REQUIRED WITH APPLICATION FOR ADMISSION PLEASE SEND AN OFFICIAL COPY OF YOUR DOCUMENTS. Documents submitted will not be returned with the exception of original documents from which LaSalle College International will have made copies. LASALLE COLLEGE INTERNATIONAL MONTREAL STUDENTS FROM OTHER CANADIAN PROVINCES OR OTHER COUNTRIES 1.Official transcript from the 11th and 12th Grades and/or 13th. 2. Official academic transcript from any post secondary college or university previously attended or in attendance at present. 3. Proxy letter authorizing a person in Canada, to act on your behalf, for your admission procedures, if applicable. 4. Applicants who have followed or who are following collegial level and / or higher level must also include: a) a copy of their cumulative report; b) a list of the courses in which they are currently enrolled. 5. Birth certificate (proof of citizenship for Canadian citizens born outside of Canada or Landed Immigrant or Diplomatic Status). 6. Working résumé (curriculum vitae) for AEC. 7. Application fee: this amount is non refundable. Please note the following: 1 The decision of the Admission Committee can be delayed if all pertinent required documents do not accompany the application form for admission. 2 Documents written in a language other than French or English must be accompanied by a translation in one of the above languages certified by the Consulate or Embassy of the country of origin. LASALLE COLLEGE INTERNATIONAL VANCOUVER 1. Registration fee: this amount is non refundable. LASALLE COLLEGE INTERNATIONAL Montréal Vancouver LaSalle College Institution Code: 2160 Institution Code: 748549 535 Howe St. Suite 200 Inter-Dec College Vancouver, B.C. Collegial Code: 749760 Canada, V6C 2Z4 Professionnal Code:105501 Phone: (604) 683-2006 2000 St-Catherine St. West Fax: (604) 683-6505 Montreal, Quebec [email protected] Canada, H3H 2T2 www.clasalle.com/vancouver Phone: (514) 939-4463 Fax: (514) 939-2015 [email protected] www.clasalle.com.