INTERNATIONAL STUDENT APPLICATION FORM
Office use only: Student ID #______________________________
PERSONAL INFORMATION
Male Female Date of Birth: Year: Month: Day: Nationality:
Family Name: Gien Name !s":
Mailin#
$ddress
Street Num%er and name:
&ity: 'roince(State:
&ountry: 'ostal &ode:
'hone Num%ers: )ome ! Include country code " *or+ ! "
,-Mail: Fa. Num%er: ! "
First /an#ua#e: Other: &ountry of Ori#in:
Contact Person in Canada !com0lete only if a00lication is %ein# su%mitted %y someone in &anada on %ehalf of the a00licant"
Name: 1ele0hone: ,-mail:
)o2 did you hear a%out St3 /a2rence &olle#e4 ___________________________________________________________________
$re you usin# a recruitin# a#ency4 Yes No
$#ent Name: ________________________________________________________________________________
$#ent ,-mail: _________________________________________________________________
PROGRAMME of STUDY
'lease enter your choice of 0ro#rammes %elo2
'5OG5$MM, &OD,
!IF 6no2n"
'5OG5$MM,
1I1/,(&$M'7S
'5OG5$MM, /,NG1) S1$51 D$1,
83
Month Year
93
Month Year
:3
Month Year
OFFI&, 7S, ON/Y:
I&$S: ____________________________________
$00lication Fee: ____________________________
,n#lish: ___________________________________
/O$ S,N1: ________________________________
ACADEMIC RECORDS
Original or Certificated coies of !o"r #ost recent $ig$%sc$ool& college or "ni'ersit! transcrit and Englis$ Testing
Scores are re("ested) Candidates #"st also send Englis$ translations *$ere necessar!) T$e doc"#ents #"st
acco#an! !o"r alication for#)
ACCOMMODATION
I 2ould li+e to a00ly for : I 2ill arran#e for my o2n accommodation
)omestay 5esidence I need assistance 2ith other housin# arran#ements
PROCEDURES FOR PAYMENT
'lease send your com0leted a00lication form to:
International Ad#issions
St) La*rence College
+,, Ports#o"t$ A'en"e
-ingston& Ontario
-.L /A0& Canada
Fa.: 8-;8:-<=<-:>=: ,mail: international?sl3on3ca $ttention: )elen &had2ic+
$ non-refunda%le a00lication fee of &$D @8AA must %e sent 2ith this form if you are a00lyin# for 0ost-secondary
0ro#rammes3 'lease ma+e drafts 0aya%le to St3 /a2rence &olle#e3
Methods of 'ayment !chec+ one":
BIS$ M$S1,5 &$5D Ban+ Draft(Money Order Other
If 0ayin# %y BIS$ or M$S1,5 &$5DC 0lease com0lete the follo2in#:
&ard Num%er:________________________________________ ,.0iry Date: ________________________
Name on &ard:______________________________ Si#nature of &ardholder:_________________________
DECLARATION
I declare the a%oe information is true and com0lete3 I understand that any false or incom0lete information su%mitted in su00ort of
my a00lication may inalidate my a00lication and result in the 2ithdra2al %y St3 /a2rence &olle#e of a 0lace 2hich may %e offered
and that this 2ithdra2al may ta+e 0lace any time in my enrolment3
I authoriDe St3 /a2rence &olle#e to o%tain details to my academic record at the institutions listed 0reiously and from 2hom I hae
0roided transcri0ts in order to ena%le my a00lication to %e considered3
Si#nature: ____________________________________________ Date: ______________________________________
$00licant
Si#nature: ____________________________________________ Date: ______________________________________
'arent ( #uardian(&anadian &ontact 'erson
!if a00licant is under 8E years of a#e"
Alication C$ec1list2
&om0leted a00lication form Ori#inal documents or certified co0ies of all academic transcri0ts and ,n#lish
lan#ua#e 0roficiency test results3
,n#lish translation of documents $00lication fee
Once !o" are acceted& !o" *ill need to co#lete t$e $o"sing alication for# if re("ired)
