Laurentian Initiative for Transition (LIFT)
Application 2019
Name: *
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Preferred Language: *
Language of Study *
Address: *
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City: *
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Province: *
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Postal Code: *
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Telephone: *
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Cellphone: *
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Laurentian Email: *
Your answer
Alternate Email:
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Emergency Contact Name and Relationship: *
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Emergency Contact Number:
Your answer
Information Regarding Disability
All information provided will be kept confidential.
Please select an option that best describes your disability. *
Do you have documentation of your disability? *
Do you have a psycho-educational assessment? *
If you answered yes above, what is the date of the assessment report?
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DD
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Residence Information
Will you be living on campus in your first year? *
If so, which residence will you be staying in?
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