Algoma U Registration Form
REG
Student Number
Surname
Date of Birth (YY/MM/DD)
Given Names
M/Sex/F
Male
Female
Social Insurance No
Principle Language of Comm.
Mother Tongue
Eng
Fr
Eng
Fr
Other
PERMANENT ADDRESS
Address 1
Address 2
City
Province | State
Postal Code | Zip
Telephone
LOCAL ADDRESS
Address 1
Address 2
City
Province | State
Postal Code | Zip
Telephone
Marital Status
Former Surname
Student Association
Session
Registration Date (YY|MM|DD)
Campus
College
Academic Program
Concentration 1
Concentration 2
Continuation
Year In Program
Enrollment
Graduating This Session
Second Degree
Full-time
Part-time
Yes
No
Yes
No
COURSE INFORMATION
Term
Subject
Number
E/F
SEC.
THIS SECTION IS TO BE COMPLETED BY ALL STUDENTS
Canadian Citizen | Native Canadian
Permanent Resident
Student Visa
Other
Country of Citizenship
