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esl@mapleleafacademy.com
Maple Leaf Academy
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Maple Leaf Academy
Information_collected for the sole use of registration at Maple Leaf Academy
First name
*
Last name
*
Email Address
*
Confirm Email Address
*
Male
Female
Home Address
*
Postal code
Telephone
*
It is your responsibility to inform the school of changes to your name, address, email address, and phone number
Date of Birth
*
Date
E.g., 01.25.2022
Immigration Number (UCI ID#)
*
Your Immigration Category located on the back of your PR Card or on your landing papers (please select one)
FC1
FC4
PV2
SW1
CRS
REF
RAS
Other
Home Country
First Language
Date of Landing
*
Date
E.g., 01.25.2022
Highest Grade Completed
0
1
2
3
4
5
6
7
8
9
10
11
12
12+
Please select the program you are interested in:
Full-time (9:00am–3:00pm)
Part-time (5:30pm-8:00pm)
Saturday (9:00am-1:00pm)
Have you attended another LINC program and received a PBLA binder?
Yes
No
Your Benchmarks (Canadian Language)
Listening
Speaking
Reading
Writing
