INTERNATIONAL APPLICATION FORM International Application #______________ (office use only) PRIMARY INFORMATION Date of Birth: Month First Name Male Female Second Name Day Year PERMANENT ADDRESS INFORMATION Street Country Last Name State Code Country of Citizenship COUNTRY AND LANGUAGE English French Other First language (basis for admission consideration): If other, please specify Secondary school graduate or equivalent Please e-mail transcripts with your application. You must bring original or certified/notarized copies with you at the time of registration. College/University studies. Yes No ADDITIONAL ACADEMIC INFORMATION Have you written the TOEFL? (550 paper and 213 computer based; 79 - 1BT) If Yes, indicate the date it was written TOEFL Score If Yes, indicate the date it was written No Yes Have you written the IELTS? (6.0 - no band score less than 5.5 accepted. For graduate programs 6.5 no band score less than 5.5) Score: Listening Reading Writing Speaking Overall Fax: 705.235.7279 | Email: [email protected]Page 1 of 4 APPLYING TO NORTHERN? 1. Complete this form. 2. Remember to sign and date this application (Page 3). 3. Fax the form to 705.235.7279 or email to: [email protected]4. Mail the original to: Northern College Admissions International Office P.O. Box 3211 Timmins, ON P4N 8R6 A $100 CAD application fee is required if no agent code. See page 4 for details. E-mail Address Number City Code Country Code TELEPHONE CONTACT INFORMATION Please have your score sheet sent to us.
Transcript
INTERNATIONAL APPLICATION FORM International Application #______________ (office use only)
PRIMARY INFORMATION
Date of Birth: Month
First Name
Male Female
Second Name
Day Year
PERMANENT ADDRESS INFORMATION
Street
Country
Last Name
State
Code
Country of Citizenship
COUNTRY AND LANGUAGE
English French OtherFirst language (basis for admission consideration):
If other, please specify
Secondary school graduate or equivalent Please e-mail transcripts with your application. You must bring original or certified/notarized copies with you at the time of registration.College/University studies.
Yes No
ADDITIONAL ACADEMIC INFORMATION
Have you written the TOEFL? (550 paper and 213 computer based; 79 - 1BT)
If Yes, indicate the date it was written TOEFL Score
If Yes, indicate the date it was writtenNoYesHave you written the IELTS? (6.0 - no band score less than 5.5 accepted. For graduate programs 6.5 no band score less than 5.5)
APPLYING TO NORTHERN? 1. Complete this form. 2. Remember to sign and date this application (Page 3). 3. Fax the form to 705.235.7279 or email to: [email protected] 4. Mail the original to:
Northern College Admissions International Office
P.O. Box 3211 Timmins, ON P4N 8R6
A $100 CAD application fee is
required if no agent code. See page 4 for details.
E-mail Address
Number
City CodeCountry Code
TELEPHONE CONTACT INFORMATION
Please have your score sheet sent to us.
INTERNATIONAL APPLICATION FORM International Application #______________ (office use only)
Is an agent (agency, company, or school) helping with apply?
AGENT DETAILS
Yes No
If Northern College has provided an agent code for your agent, please enter the code and agent information:
Code
Agency Name
Address 1
Address 2
Address 3
City
Country
Province/State
Fax Number
Phone Number
Postal Code
Email
Do you want communications to go through the above company, agency or school?Yes No
INTERNATIONAL APPLICATION FORM International Application #______________ (office use only)
1. Program
PROGRAM SELECTION (IN ORDER OF PREFERENCE)
Length
Start Date
Start Date
Length
2. Program
Freedom of Information and Protection of Individual Privacy Act: 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 Northern College and/or the Ministries and Agencies of the Government of Ontario and the Government of Canada. For Further information, please contact Student Services, Northern College, P.O. Box 3211, Timmins, ON, P4N 8R6.
I 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.
INTERNATIONAL APPLICATION FORM International Application #______________ (office use only)
STUDENT INFORMATION
Last Name
Cardholder's Name
Expiry Date
Credit Card Number
Application Payment Information
VISA or MasterCard Wire Transfer
VISA or MasterCard Information
Cardholder's Signature
The following information will be required for a wire transfer: BANK TRANSFER DETAILS Bank: Royal Bank of Canada Address: 38 Pine Street North, Timmins, ON Canada P4N 6K6 Bank#: 003 Transit #: 05112 Account #: 000-013-3 Swift Code: ROYCCAT2 PLEASE INCLUDE APPLICANTS FULL NAME WHEN MAKING WIRE TRANSFER Please ensure the College is notified when the transfer has been processed and the amount of the transfer as it will be important to verify the deposit and to process the payment on your account. REFUND POLICY Please see the following web site page for more information http://www.northernc.on.ca/international
