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PERSONAL INFORMATION
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EDUCATIONAL BACKGROUND

A. Currently Attending School
High School :
Principal :
Guidance Councillor :
Telephone :
Current Grade/Level :

B. No Longer Attending High School
High School Attended:
Grade/Level Attained :
Did you Graduate? : (Yes/No)
Year Completed / Graduated :
If you answered "No" to the above please indicate if you have obtained any further academic upgrading: :

C. Other College / University / Programs completed:
Program/Degree College/University Year Completed Graduated (Y/N)

EMPLOYMENT BACKGROUND
Please provide the following detail of your last two (2) employers
Employer Position Period of Employment

ENROLLMENT INFORMATION
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Preferred Starting Year :  (required)
How Did You Hear About Keyin College? :
Referred By :
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OPTIONAL INFORMATION
Please indicate whether you intend to apply or have applied for any of the following sources of financing:
Canada Student Loan :
Provincial Government Sources :
Services Canada (HRD) :
Worker Compensation Commission :
Please indicate any medical condition(s) of which we should be aware:
Email Address :
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