Information Required for Applying to
Thompson Rivers University

Complete this form as best as you can and in your best English.
If you need help with any item, type a "?" in the item's response box.
Enter your questions or explanations in the "Question / Comment Box" you see at the end of each section.

Student's Personal Information
Last Name:
First Name:
  Middle Name:
  English Name:
Gender Male Female
Address:
City:
  Province / State / Region:
Country:
  Postal Code:
Citizenship:
  Birthplace:
Birthday:
  Phone:
  Fax:
E-mail:
Confirm E-mail:
Question or Comment Box for Student Information.
If you need more than 5 lines, send us an email after you submit this form.

Program Choice
Do you want to study English as a Second Language (ESL) at TRU?
Yes  No
If 'yes' which program?  Semester-based ESL Super Plus
Other
Do you want to enter a college or university program (other than ESL) at TRU?
Yes; No
If 'yes' which program?
*
When do you want to begin your program?
May 2008 September 2008 January 2009 May 2009 September 2009
Have you already requested/receivedyour admissions info. pkg?
Yes  No
Do you want to be listed in the TRU Student Directory?
Yes  No
Do you want to receive email bulletins?
Yes No
Question or Comment Box for Program Information.
If you need more than 5 lines, send us an email after you submit this form.

Education History
Senior High School Attended?
From year:   to    Grade completed: 

University or College Attended:
1) 
      Dates Attended: 
from  to   (yyyy/mm/dd)
      Degrees/Dipl. Granted: 
2) 
      Dates Attended: 
from  to   (yyyy/mm/dd)
      Degrees/Dipl. Granted: 
3) 
      Dates Attended: 
from  to   (yyyy/mm/dd)
      Degrees/Dipl. Granted: 
What did you do last year?
Secondary School  College University  Labour Force  Other
Where did you live last year? British Columbia  Another Province  Outside Canada
List below your questions OR make comments OR request other things you would like to know.
If you need more than 10 lines, send us an email after you submit this form.

Did you enter your email address?   We need that to help you.

Declaration: I understand and agree that this is an application for a TRU program only and is subject to the limitations of available resources. I certify that all statements on this application are true and complete. I understand any misrepresentation of this information may result in the cancellation of my admission or registration and that information placed in my student record will be used for the purposes of admission and registration and other purposes consistent with the Colleges and Institutes Act and the BC Freedom of Information and Privacy Act.

I Agree with the above declaration

To Kamloops International Student Services

Agent Information

Name of Agency: Kamloops International Student Services
Contact Name: Yoko Haneda (Agent No: 535)
Address: 738 Chaparral Place
City: Kamloops
Country: Canada
Postal Code: V2C 5W4
Phone: 250-374-9235
Fax: 250-828-8700
E-mail: yoko@kicollege.com

Note: A non-refundable CDN$100 application fee must be submitted with your application.
          As your agent K.I.S.S. will pay this for you.