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- Admission - Application Form



Personal Details 

Family Name:____________________                          Given Name:_____________

Preferred Name: ____________________                      Gender: ____________

Date of Birth (dd/mm/yy): ______/_______/__________       Country of Birth:_______________

Status in Canada: 

Home Address:


City: _____________      Province: ______________  Postal Code________________                                                

Phone:_____________________                       Email:______________________________________


Parent / Guardian Contact

Name:__________________________                      Phone(Home):_______________________

Relationship:_________________________                      Phone(Business):_____________________


Education Background 

Previous School(s) Attended

High School Name


From (mm/yy)

To (mm/yy)

Certificate or Diploma Obtained












TOEFL score:________________               Other English test score____________


Academic Program/Course Applying For

Course Code

Course Name


Start Date

( semester/year )

Class Time
















I have provided the following supporting documents:

 Identification       Transcript        Report Card     Credit Summary      Others

If I am accepted as a student at CIA, I hereby agree to abide by all the rules and regulations of the School. 

I hereby declare that the information given in this application form is to the best of my knowledge complete and correct.

School shall under no circumstances be liable for any loss, damage or injury.


Signature of Applicant:_________________________               Date (dd/mm/yyyy):__________________________


Name of Parent or Guardian (if applicant is under 18):_________________     Date (dd/mm/yyyy)______________



Application Form.pdf


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