Self-Reported Grades (Canadian Curriculum)

This form is intended for individuals applying to Western University who are studying a non-Ontario Canadian Secondary School curriculum.

NOTE: If you are not studying a Canadian curriculum, please do NOT complete this form. Send your transcripts.


  • Please indicate ALL grade 11 and 12 midyear and/or final grades as they will appear on your transcript. This information will be verified with your official secondary school transcript once received by our office.
  • Please ensure your list of grade 12 courses includes ALL courses that you have completed by June 2014. If no grade for a course is currently available, please leave the grade column blank.
  • Do not use short forms and ensure that all numerical values are represented as numbers and not words.
  • Indicate all Advanced Placement (AP) of International Baccalaureate (IB) courses in the “Course Title” area.

Contact Information

Secondary School Information



All Information on this form must be provided in full or this form will not be used to support your application.