In

nternatiional Sttudent Cambriann Colleg

ge of
A
Applica
ation Form
F Applied Arts
A and
d Techn
nology
1400 Barrydowne
B Road
d, Sudbury, Onta
ario, Canada P3A
A 3V8

INTERN
NATIONAL OFFICE
O P 705--566-8101 ext. 78841 F 705-560--9652 E internaational@cambriaancollege.ca

APPLICA
ATION CHECKL
LIST
Photo and Signature page(s) of
o Passport

Notarized/Atte
ested copies of all Secondary and
d Post Secondarry Transcripts&Diplomas

PERSONAL INF
FORMATION

Mr. Mrss. Ms. Miss Cam

mbrian College ID: __________
_______  None
Last name: Prevvious last name (if changed):
First name: Middle name: 
Date of birth (yy//mm/dd): SPP Applicant?  Yees  No
C
Country of Citizzenship: Passport Nu
umber: Stud ached?
dent Permit Atta  Yees  No
A
APPLICANT’S P
PERMANENT MAILING ADDRE
ESS
S
Street Name and
d Number: Apa
artment Numberr:
C
City: Province/S
State: Cou
untry: Posstal Code:
Phone Number:
Personal Email:

ENGLISH SCOR
RES (IELTS)
Overall Band Score
S Listening Re
eading Writing Speaking

PROGRAM INFO
ORMATION

Program Code Program length Seme

ester Starrt date (year/mo
onth) Campus

1 semester Fall
EMERGENCY CONTACT
C
Name: Relation:
S
Street Name and
d Number: Apartment Number:
N
C
City: Provvince/State:
C
Country: Postal Code:
C
Phone Number: E-mail address:
a

A
AGENCY INFOR
RMATION (if app
plying through a re
egistered agent of Cambrian Colleg
ge)

A
Agency: C
Contact Perso
on: Email:

A
APPLICANT’S S
SIGNATURE
FREEDOM OF INFORMATION AND PROTECTION OF INDIVIDUA AL PRIVACY
I certify that the above information is true and comple ete. I understand that - The inforrmation on this forrm is collected unnder the legal autthority of the
a false or incom
any mplete information submitted in suppport of my applicattion Ministry of Colleges and Uniiversities Act, R.S.O. 1990, c.M.19, s.5.; R.R.O.
m invalidate my application. I have
may e read the Freedoom of Information and
a 1990, Reg.. 770. The inform mation is used forr administration and statistical
Protection of individual Privacy statem
ment. I authorize Cambrian
C Collegee to purposes off the college and/o nd Agencies of the Government
or the Ministries an
i
interact/exchange e information wiith my agent with w respect to mym of Ontario and the Governm ment of Canada. ForF further informa ation, please
a
admission to Cammbrian College. contact the Registrar of the College
C for which th
he application is be
eing made at
the addresss and telephone number on this page..

S
Signature of applicant:
a Date: