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Student Information

First Name*

Last Name*

Phone Number*

Email Address*

Gender*

Country Of Citizenship/Origin*

Date of Birth*

Home Address*

Contact Information In Case of Emergency

Person To Be Contacted*

Relationship*

Name Of Your School In Canada*

Name Of Your Landlord*

Phone Number*

Email Address*

Your Home Address in Canada

Home Address*

Address Line 1

Address Line 2

City*

Province*

Postal Code*

Arrival Date

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To*

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