| Student Information |
| Applying For: |
Select a Start Date:
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Select a End Date:
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| Last Name: |
First Name: |
Middle Name: |
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| Country of Birth: |
Citizenship: |
Mother's Birth Date*:
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Father's Birth Date*:
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| *Mother's and Father's birth date are required for a Custodianship Letter |
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| Status in Canada: |
Language spoken at home:
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| Student Home Address: |
City:
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Province/State:
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Postal/Zip Code:
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Country:
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Student Email Address:
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| Student Phone Number
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| Family - Father's Information |
| Please fill in appropriate information about Applicant's Father. If there is additional information that needs to be offered, please use the "Other" box provided at bottom of application.
If the address for the Father is the same as the Mother, please check mark this box: |
| Father's Name: |
Father's Address:
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City Name: |
Province/State:
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Postal/Zip Code:
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Home Tel #:
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Home Fax #:
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Email Address:
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Occupation:
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Title:
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Business Name:
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Business Address:
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City Name:
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Province/State:
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Postal/Zip Code:
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| Business Email Address: |
Business Phone Number
Business Fax Number:
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| Family - Mother's Information |
| Please fill in appropriate information about Applicant's Mother. If there is additional information that needs to be offered, please use the "Other" box provided at bottom of application. |
| Mother's Name: |
Mother's Address: |
City Name:
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Province/State: |
Postal/Zip Code: |
| Home Tel #: |
Home Fax #: |
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Email Address:
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Occupation:
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Title:
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| Business Name: |
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Business Address:
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| City Name: |
Province/State: |
Postal/Zip Code: |
| Business Email Address: |
Business Phone Number
Business Fax Number:
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| Agent Information |
| If Applicable: Please fill in appropriate information about Applicant's Guardian or Agent. If there is additional information that needs to be offered, please use the "Other" box provided at bottom of application. |
Agent Name:
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Agent Company Name: |
| Agent Email Address: |
| Guardian Information |
Guardian's Name:
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Relationship to Student:
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Guardian's Address:
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City Name:
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Province/State:
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Postal/Zip Code: |
Home Tel #:
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Home Fax #:
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| Do you wish to send copies of the student's reports to the Guardian? Yes No |
| Academic Information |
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| Please provide previously attended school information, if applicable. |
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Name of School:
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School Address:
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City Name:
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Province/State:
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Postal/Zip Code: |
| School Phone Number:
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| Other Information |
Please select three (3) boarding schools that you would like to attend:
School #1:
School #2:
School #3:
Comments:
Important: Please forward a copy of most recent school report and copy of birth certificate or passport to Fulford Academy (613) 341-9344. We also require two (2) recent photos and an application fee of $200.00 (Canadian Dollars).
By submitting this application you are authorizing Fulford Academy to contact you in regards to the application that has been received.
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