Agent Online Application Form Step 2 Please re-enter applicant first name, last name, and email as stated on previous screen. First Name * Last Name * Email Address * Former Surname (if applicable) Background Information Have you previously applied to Brescia/Huron/King's/Western? Yes No Are you applying to the Preliminary Year program? Yes No If yes, what undergraduate program do you hope to study after Preliminary Year? Arts or Social Sciences Engineering Foods and Nutrition Health Sciences or Kinesiology Management and Organizational Studies Sciences Are you the first in your family, including your sibling(s) and parents to attend university or community college? Yes No English Language Proficiency First Language English French Other Please specify first language if not English of French Have you studied in English (ESL excluded) at an English medium institution for a minimum of 4 years? Yes No If yes, please check at which institution: High school University College Other If no, please provide proof of English proficiency: Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Academic Records ALL SECONDARY SCHOOLS ATTENDED - OFFICIAL TRANSCRIPTS ARE REQUIRED Transcript 1 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Transcript 2 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Transcript 3 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB ALL POST-SECONDARY EDUCATION UNDERTAKEN INCLUDING COLLEGES AND UNIVERSITIES - OFFICIAL TRANSCRIPTS ARE REQUIRED Transcript 1 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Transcript 2 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Transcript 3 Drop a file here or click to upload Choose File Maximum upload size: 2.1MB ACCOUNT FOR ALL YEARS NOT IN SCHOOL - Including employment, homemaking, travelling, etc. By checking below, you certify that all statements are correct and complete including my Declaration of Citizenship and Status in Canada. I understand that I may have to provide further documentation at some further date to substantiate my claim and that any misrepresentation of this data may result in the cancellation of my admission and/or registration. I understand that in the case of suspected misrepresentation other academic institutions may be contacted. * I Agree