York Application

Personal Info

Title
Legal First Name
Common Name
Middle Name
Legal Surname
Former Surname
Gender
Email
Date of Birth
Previously Applied?
If yes, when?
Previous York Student Number
OEN
Country of Citizenship
First Language
Correspondence Language
Citizenship Status
Month of Arrival
Year of Arrival
Agency
Cohort

Address

Permanent Address Line1
Permanent Address Line2
Permanent City
Permanent Province/State
Permanent Free-Form Province/State
Permanent Postal/Zip Code
Permanent Country
Same mailing address?
Mailing Address Line 1
Mailing Addresss Line 2
Mailing City
Mail Province/State
Mail Free-Form Province/State
Mail Postal/Zip Code
Mail Country

Phone Numbers

Home Phone
Business Phone
Business Phone Ext
Mobile Phone

Post-Secondary School

Attended Post School?

1st Entry

Post School Name
Graduated?
Diploma Name
Country
City
Address
Month Start
Year Start
Month End
Month Year
Major
Validated Institution

2nd Entry

Post School Name
Graduated?
Diploma Name
Country
City
Address
Month Start
Year Start
Month End
Year End
Major
Validated Institution

3rd Entry

Post School Name
Graduated?
Diploma Name
Country
City
Address
Month Start
Year Start
Month End
Year End
Major
Validated Institution

Goal of Study

Gr Program (SEQ)
Session
Activity
Study Level

Misc

Aboriginal?
Parents attended Uni?

Declaration and Consent

Y/N