First Name

Last Name

Email Address

Number of Accompanying Guests Number of Accompanying Guests123456

Intended Start Semester Intended Start SemesterWinterFall

Intended Start Year Intended Start Year2025202620272028

Program ProgramHealth SciencePure and Applied ScienceGeneral Social ScienceSocial Science: CommerceEarly Childhood EducationSpecial Care CounsellingSpringboard to a DECGrade 12University Prerequisites

High School Name

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