Queen City Collegiate, Canada

Your Contact information

FULL NAME
Country
Province
City
Address
Address
Postal Code
Telephone
Fax Number
E-mail

Date of Birth
Sex	Male Female

Your present academic Background

University Year One
University Year two
College Year one
College Year two
College Year three
Senior Middle School Year 3
Senior Middle School Year 2
Senior Middle School Year 1
Junior Middle School
Others

Which course you want to apply?

University AP Program
Pre-University Course
Grade 9-12
EAP Program
Summer Course

Which school term you want to apply?

September - January
February - June
July - August

Date

-- dd/mm/yy

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