International Students Application Form

If you are interested in submitting an international application to Centennial College online, please follow these steps:

Complete the following international education application form
If you wish to clear the fields you filled in, click the Start over button at the bottom of the form
When completed, click the Submit my application button
Finally, you must then submit transcripts and any other academic information by one of the following methods:

Mailing Address: Centennial College International Education Office P.O. Box 631 Station A Scarborough, Ontario, Canada M1K 5E9	Courier Address: Centennial College International Education Office (C2-07) 941 Progress Avenue Toronto, Ontario, Canada M1G 3T8 Phone: 1-416-289-5393
Scan and Email: international@centennialcollege.ca	Fax: 1-416-289-5352

If you prefer, you may complete, print and fax this form to 1-416-289-5352.

Note: Required fields are indicated with an *.

Part One
Salutation
* Mr. Mrs. Ms. Miss
* Male Female

Permanent Mailing Address
*Last Name:
*First Name:	Second Name:
*Address:

Apartment #: *City: Province/State:
*Country:
Postal Code/ZIP:

Telephone / Fax
Country Code:
Home	- Area/Region Code:	Number:
Work	- Area/Region Code:	Number:	Ext:
FAX	- Area/Region Code:	Number:

E-mail Address:

*Birth Date:
*Month: *Day: *Year:

*Country of Citizenship:

Canadian Social Insurance Number (if you have one):

*Preferred Language
English	French
Other - Please specify:

*Basis for Admission Consideration

Secondary school graduate or equivalent

College/university studies

Please remember to mail or fax original transcripts or certified copies to the address shown above!

Additional Academic Information
Related work experience (please send résumé)

Have you written the TOEFL* (Test Of English as a Foreign Language)?
Yes
No

If you answered yes, please provide the following information:

Date written: Month Day Year Your score:

*Type of TOEFL test taken: Paper-based Computer-based

*Have you written the IELTS (International English Language Testing System)?
Yes
No

If you answered yes, please provide the following information:

*Date written:	Month:	Day:	Year:
*Your Score	Listening:	Reading:	Writing:
	Speaking:	Overall Score:

Program Selection (in order of preference)

*1.

*Semester

Semester

Authorization

I hereby certify that the above information is true and complete. I understand that any false or incomplete information submitted in support of my application may invalidate my application. I have read the Freedom of Information and Protection of Individual Privacy Statement (see below).

Freedom of Information and Protection of Individual Privacy Act: (read me...)

The information on this form is collected under the legal authority of the Ministry of Colleges and Universities Act, R.S.O. 1980, Chapter 272, S.S.,: R.R.O. 1980, Regulation 640. The information is used for administration and statistical purposes of Centennial College and/or the Ministries and Agencies of the Government of Ontario and the Government of Canada.

For further information, please contact:

The Registrar's Office
Centennial College
P.O. Box 631, Station A
Scarborough, Ontario,
Canada M1K 5E9

*Applicant Signature: By clicking this checkbox, you are agreeing to the terms of the Freedom of Information and Protection of Individual Privacy Act as specified above.

Part Two
How did you first learn about Centennial College?
Canadian Embassy	Educational resource in your home country
Education Fair	Friend or Relative in Canada
The Internet	Friend or Relative at home
Centennial Graduate	Educational Publication:
Agent	Other:

Who encouraged you to apply?
School Counsellor	Parent
Agent	Other:

Have you attended school or college in Canada before?
Yes	No

If yes, please list the names and addresses of schools, and the programs and dates attended:
School	City	Program	Start Date	End Date

Future Education and Career Goals
If you are applying for English as a Second Language or English for Academic Purposes, do you plan to continue post-secondary study after your English course is completed?
Yes	No
If yes, what programs interest you?


Do you plan to complete a diploma program and go on to university?
Yes	No

Are you planning to work in Canada for one year after graduation (as permitted by Immigration Canada)?
Yes	No

Part Three

If you have a contact person in Canada, please fill out the following section.
Information Release Pursuant to the Freedom of Information and Protection of Individual Privacy Act, I hereby authorize Centennial College to release any and all information related to any and all aspects of my application for admission, acceptance, fees or program of studies to the person whose name and address appears below. I certify that the person named is my selected representative and has my agreement to access and use this information to assist me to successfully register and access programs at Centennial College.

I authorize information release to my contact in Canada:

Applicant Signature: If you have provided information for a contact in Canada, please read the above terms and click the signature checkbox at left. By clicking this checkbox, you are agreeing to the terms of the Freedom of Information and Protection of Individual Privacy Act as specified above.

Contact's Name and Address
Contact's Name:
Contact's Address:
City:
Province:

Contact's Telephone, Fax and E-mail:
Phone:	Area code:	Number: -
Fax:	Area code:	Number: -
E-mail address:

Have you checked all your entries and verified that they are correct?

International Students Application Form

Part One

Part Two

Part Three