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Student Information Verification
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* Indicates required question
Student Legal Name:
*
Your answer
Student Preferred Name:
Your answer
Student Date of Birth:
*
MM
/
DD
/
YYYY
Indigenous ID:
Column 1
First Nation
Inuit
Metis
Native Student on Reserve
Native Student off Reserve
Column 1
First Nation
Inuit
Metis
Native Student on Reserve
Native Student off Reserve
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Student Home Address:
*
Number/Street Unit/Apt# City Province Postal Code
Your answer
Student Mailing Address (if different from Home Address):
Number/Street Unit/Apt# City Province Postal Code
Your answer
Student Home Phone Number:
*
Your answer
Student Health Card Number:
Your answer
Medical Alert Information/Disability/Allergies:
Your answer
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