International
Student Application Form
Rockway Mennonite Collegiate, Canada
PLEASE COMPLETE FORM AND
FAX or MAIL to:
FAX 001
519-895-2912
(Do NOT transfer funds at this time,
make sure you FIRST contacted Dr. Herminio Schmidt)
Dr. Herminio Schmidt, 51-165 Chandos Dr.
Kitchener, ON, Canada N2A 4A2
Phone: [001] 519-895-2880 Fax:
[001] 519-895-2912 E-mail: info@english-in-canada.com
FAX first:
This application with most recent academic transcript and a letter of
reference from a teacher and one from another professional who is familiar
with the applicant.
Airmail all originals
with 2 photos to the above address.
We will confirm and inform you of how to proceed. The school will
again review your documents and inform you of your acceptance.
Only then will you have to transfer the tuition to the school.
( Have you cleared all questions with
Dr. Herminio Schmidt ?
)
SCHOOL YEAR 200 ___ to 200 ____
PLEASE CHECK: Semester I only ___ Semester
II only ___ Both
Semesters (full school year - 10 months) ____
1. Application for Grade 7 ____,
8 ____, 9 ____, 10 ____, 11 ____, 12 ____, OAC
____
2. Name in Full ________________________________________________________________________________
(Family Name -
Given Name - Middle Name)
Date of application __________________
3. Home Address_______________________________________________________________________________
City and Postal
Code ___________________________________________________________________________
Phone _______________________________________
Fax ___________________________________________
E Mail _______________________________________
_____________________________________________
4. Date of Birth_________________________
Place & Country _____________________________
(Day--Month--Year)
Sex : Male ___ Female ___
5. Do you have a guardian in
Canada? No____ Yes
____ If yes please fill in the following:
Guardian's Name ______________________________________________________________________________
Guardian's Address ___________________________________________________
Postal Code______________
Guardian's Phone ___________________________________
Fax ______________________________________
6. Parents: Father_____________________________________________________________________________
(Family Name -- Given Name -- Middle Name)
Mother______________________________________________________________________________________
Family Name -- Given Name -- Middle Name) Address (If
different from Home Addres above):
________________________________________________________
Postal Code ________________________
Father's Occupation _____________________________________
Business Phone_______________________
Mother's Occupation _____________________________________
Business Phone ______________________
7. Church you and your family attend _____________________________________
Members? Yes___ No ___
8. Name of school attended last
year ____________________________________________________________
Address ____________________________________________________________________________________
Principal__________________________________________
Phone ____________________________________
9.List special interests ________________________________________________________________________
___________________________________________________________________________________________
10. List special training ________________________________________________________________________
___________________________________________________________________________________________
11. State why you have chosen
to attend Rockway Mennonite Collegiate _______________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
12. List name(s) of your brother(s)/sister(s)
who will be attending Rockway at the same time as you.
NAME(S)________________________________________________________________
Grade _____________
NAME(S)________________________________________________________________
Grade _____________
13. List three persons of your
acquaintance (your minister, teacher, and one other reference) whom
the school may
contact for reference. (To be filled out by students applying to
Rockway for the first time.)
Name_____________________________
Address _________________________________________________
Occupation ________________________
Phone __________________________Fax _____________________
Name_____________________________
Address _________________________________________________
Occupation ________________________
Phone ___________________________Fax ____________________
Name______________________________
Address_________________________________________________
Occupation _________________________
Phone ___________________________Fax ___________________
14. It is assumed that your
signature on this application indicates your intention to take seriously
your studies and your willingness to pursue the purpose and aims
of Rockway:
_______________________________________________________________
(Signature of Applicant )
15. As parent/guardian I approve
the applicant's enrollment at Rockway Mennonite Collegiate and will be
ready to counsel together with him/her and the faculty and staff
to help strengthen the purpose of Rockway. I shall meet the financial
obligation promptly.
_______________________________________________________________
(Signature of Parent/Guardian)
Please complete the application
in full and return to:
Dr. Herminio Schmidt, 51-165
Chandos Dr., Kitchener, ON Canada N2A 4A2
Fax: [001] 519-895-2912
with:
1) The student's most recent academic
transcript
2) Two pass photos
3) Language
Assessment
4) Two
letters of references from a professional who has known the applicant
for at least two years
______________________________________________________________________
NOTE: If your application is
accepted, you will need to pay the full tuition fee, in addition to the
Health Insurance fee and fees for Room and Board for the host family.
After payment has been received, the school will issue an official
"Letter
of Acceptance"
to be presented to the Immigration authorities for a student visa.
Tuition fees are non-refundable
unless a student is unable to obtain a student visa or if a student decides
to withdraw the application before April 30. Requests for refunds
after April 30 must be accompanied by a letter from the Canadian Embassy stating
that the visa application has been refused. A $250 administrative fee
will be withheld on all refunds.
___________________________________________________________________________
For Office Use
Only:
Date Received: ______________________________
Host Family/ Address_________________________________________________________________________
Postal Code_____________ Phone ________________________ Work Phone __________________________
Tuition Balance _____
Room and Board Fees_____
Health Insurance ______
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