INTERNATIONAL EDUCATION SERVICES

ADMISSION APPLICATION FORM

FOR OFFICE USE ONLY
Application #: Student # Date Received:

1. PERSONAL INFORMATION
Family Name Given Name(s)

Date of Birth / / Country of Birth Gender Male

Month Day Year Female
Personal Email
(print clearly) Agent
PERMANENT MAILING ADDRESS (in Home Country)

Street
Postal Code
City (PIN Code) Country

Phone: ( ) Alternate Phone: ( ) Fax: ( )

Emergency Contact: Phone: ( )

MAILING ADDRESS IN CANADA (if applicable)
Street

City Province Postal Code

Phone: ( ) Contact Person in Canada

2. POSTSECONDARY PROGRAMS
Program Name Campus Program # Start Date (with Year)

First Choice

Second Choice

GENERAL ARTS & SCIENCE – APPLIED COMMUNICATIONS / ENGLISH AS A SECOND LANGUAGE

January/Winter May/Spring September/Fall
Year Year Year

3. ENGLISH PROFICIENCY (indicate where applicable)

IELTS Score Reading Writing Listening Speaking Overall
TOEFL Score Overall Paper Based Computer Based Internet Based
Date IELTS/TOEFL completed: If not already complete indicate IELTS/TOEFL test date:

4. MAILING INSTRUCTIONS (PLEASE SELECT 1 ONLY)

Mail to International Address Mail to Address in Canada Prepare my Offer for Pick Up

Send my offer electronically by email

Print your email address CLEARLY (Originals will not be sent by mail)

MOHAWK COLLEGE INTERNATIONAL EDUCATION SERVICES

135 Fennell Ave W, Hamilton, Ontario L9C 1E9 CANADA
Phone: 905-575-2254 Fax: 905-575-2362 Email: intered@mohawkcollege.ca Web: www.mohawkcollege.ca/international
1
 INTERNATIONAL EDUCATION SERVICES
ADMISSION APPLICATION FORM
5. ADDITIONAL SERVICES (Check those that apply)
Do you require Airport Pick Up? Yes (please contact our office) No, thank you
Do you require Homestay Service? Yes (please contact our office) No, thank you
Do you prefer a home with pets?
Do you prefer a home with children? I would not mind other roommates
Do you have any Allergies? If yes, please explain:
Please indicate what activities you enjoy (i.e. hiking, cycling):
Any other information that might help in selecting a
homestay placement:

6. APPLICANT CHECKLIST
I have enclosed the following payments with my application:
$100 Application Fee $400 Confirmation Fee (Optional) To hold a seat in your program of
$125 Airport Pick Up Fee (one way)(if applicable) choice until the remainder of fees are due.
$100 Homestay Finders Fee (if applicable)

I have enclosed the following required documents (for Postsecondary Application only)
Application Form
Translated and notarized transcripts from senior secondary school and/or other level of education
Translated and notarized secondary school diploma(s) from other level of education
TOEFL or IELTS testing scores or English Credit, Ontario Secondary School Diploma (Grade 12)

7. PAYMENT INFORMATION (Please indicate below your method of payment)

Certified Cheque Money Order Bank Draft Bank Transfer
(Please contact our office for details)
Make certified cheques, money orders, and bank drafts payable to Mohawk College.

If paying by VISA or MasterCard, please complete the following: VISA MasterCard

Card Number: Expiry Date:

Name on Card:

Signature of Cardholder:

8. DECLARATION / RELEASE OF INFORMATION

I declare that the above information is true and complete. I understand that any false information submitted in support of my
application may invalidate my application and result in withdrawal of a “Letter of Acceptance” and/or registration. This withdrawal
may take place at any time during my enrolment and information will be given to Canada Immigration.

Signature of Applicant: Date:

Freedom of Information and Protection of Privacy Act. The information on this form is collected under the legal authority of the Ministry of
Education and Training, R.S.O.. 1990, cM19:R.R.O 1980, Reg 770. It is used for administrative and statistical purposes. For further information,
please contact the Registrar, Mohawk College, P.O. Box 2034, Hamilton, ON L8N 3T2 or www.mohawkcollege.ca

MOHAWK COLLEGE INTERNATIONAL EDUCATION SERVICES

135 Fennell Ave W, Hamilton, Ontario L9C 1E9 CANADA
Phone: 905-575-2254 Fax: 905-575-2362 Email: intered@mohawkcollege.ca Web: www.mohawkcollege.ca/international
2