1 of 11 A. Personal Information UW Student ID Last Name First Name Permanent Mailing Address Street City Province - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon Postal Code Phone Email Address Local Address while attending University of Waterloo Street City Province - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon Postal Code Phone Citizenship/Residency Status Canadian Citizen Canadian Permanent Resident Student Visa Other Enter other… Marital Status: Single Married Do you have any dependent children? Yes No Number of children Age of children Have you lived in Ontario for at least 12 months in a row, up to the beginning of your post-secondary studies? Yes No Leave this field blank
1 of 11 A. Personal Information UW Student ID Last Name First Name Permanent Mailing Address Street City Province - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon Postal Code Phone Email Address Local Address while attending University of Waterloo Street City Province - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon Postal Code Phone Citizenship/Residency Status Canadian Citizen Canadian Permanent Resident Student Visa Other Enter other… Marital Status: Single Married Do you have any dependent children? Yes No Number of children Age of children Have you lived in Ontario for at least 12 months in a row, up to the beginning of your post-secondary studies? Yes No Leave this field blank