PERSONAL INFORMATION
Citizenship: ___________________________________________________________________________________________________________
Male
Female
Age ________
APPLYING TO ALGONQUIN
A. Applying for Academic Studies
Program Name:
m Fall
REQUIRED DOCUMENTS:
m Winter
m Spring
NOTE: When applying to both ESL and an academic program using the same application form,
you are required to submit the non-refundable application fee of $95.
CONTINUED ON BACK
m Friend
m Internet
m Education Fair
m Facebook
m Algonquin Site
m Other ___________________________________________________________________________________________________________
If applying through an agent or family member, please provide the full name and contacts:
Name of Agency or Family Member: _____________________________________________ Agent # (if applicable) ___________________
Telephone and Fax numbers: _________________________________________________________________________________________
Email: ____________________________________________________________________________________________________________
HOUSING
m Homestay
m Living with family members or friends
m Residence/Dormitory
m I will arrange my own accommodations.
METHOD OF PAYMENT
Please indicate how you are submitting your payment of $95 CAD
m Visa
m Master Card
m American Express
m Certified Cheque
m Bank Transfer
Bank of Montreal
1381 Woodroffe Avenue, Ottawa, Ontario, Canada K2G 1V7
026 0077 60
24426
1056-981
BOFMCAM2
Algonquin College
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