| UT Student Number (if applicable) |
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| Date of Birth (YYYY-MM-DD) |
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| CDN Social Insurance Number |
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 | Enter a valid email address. Example: name@company.com |
| Personal and Legal Information for Statistical Purposes |
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| Date Entered Canada (YYYY-MM-DD) |
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| Program Information |
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| Name and contact information of person providing letter of recommendation |
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| Academic Background |
| 1. Post-Seconday Educational Institution (provide institution name, dates attended, name of degree and date degree was conferred) |
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| 2. Post-Seconday Educational Institution (provide institution name, dates attended, name of degree and date degree was conferred) |
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| 3. Post-Seconday Educational Institution (provide institution name, dates attended, name of degree and date degree was conferred) |
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| Employment History |
| 1. Employer, Position, Date Started, Date Left |
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| 2. Employer, Position, Date Started, Date Left |
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| 3. Employer, Position, Date Started, Date Left |
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| 4. Employer, Position, Date Started, Date Left |
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| 5. Employer, Position, Date Started, Date Left |
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| How did you hear about Emmanuel College? |
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| Have you attended an event for prospective students? If so, when? |
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| I hereby cerify that all statements made on this applicaiton are correct and complete |
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