2017 China - Canada Young Leaders Program - 2017 Le Programme Chine - Canada pour les jeunes leaders: from 2017-09-01 to 2018-03-31

Please use this form to register for your program.

The questions in the "Socio-demographic information" section are for statistical purposes: they are required by our funding agency (the Canadian International Development Agency) and they also help us maintain diversity in our programming. Confidentiality will be respected.

Thanks in advance

About You

First name
Last name
Gender
Cell phone number
Your e-mail address
Please re-enter your e-mail address
Birth date
yyyy-mm-dd (example: 1984-02-15)
Citizenship
English proficiency
French proficiency
Mandarin proficiency
Proficiency in another language
 

Passport

Last name on passport
First name on passport
Passport Number
Issuing Country
Passport Expiry Date
(yyyy-mm-dd)
 

Documents

As a participant in the program, you are requested to provide the following:

A copy of your passport

A scanned color copy of your Passport ID page that contains your photo, date of birth, passport number, etc.

PDF, JPEG, PNG, format only, maximum 2 megabytes.

Copy of Permanent Resident Card, if applicable

A scanned color copy of your Permanent Resident Card on both sides that contains your photo, date of birth, Permanent Resident number, etc.

PDF, JPEG, PNG, format only, maximum 2 megabytes.

Proof of Academic enrollment

Letter from the Dean, Registration office, Department or Academic Program Head, Personal.

PDF, Word, JPEG, PNG, format only, maximum 2 megabytes.

Personal Statement of Study

Write a Personal Statement of Study. Your Personal Statement of Study provides us with further information about you that will be used in reviewing your application. Discuss special academic interests and achievements, work experience (including volunteer work), special skills, personal attributes and any other significant life experiences (e.g.: family-related, travel, etc.)

Explain how the Program will expand your capacity to learn, complete certain requirements for your major, make progress toward your degree in general, classes offered abroad that are not available at your home university and describe how you will plan for your studies.

The personal statement must be composed entirely by the applicant and should be a maximum of 500 words (Times New Roman 12 point font, single spaced).


PDF or Word format only, maximum 2 megabytes.

Resume - Curriculum Vitae (CV)

Please upload your CV/Resumé. You can save most formats as PDF.

PDF or Word format only, maximum 2 megabytes.
 

Your Current Address

Your current address is where you can be most easily contacted (your university residence address, for example).

Street address Apt
City
Province
Country
Postal code
(example: H2H 2G5) Click here if you don't know your Postal Code
Telephone at this address (incl. area code)
(example: 514-931-3526)
This address is valid until
yyyy-mm-dd (leave blank if address will remain valid indefinitely)

Your Permanent Address

Your permanent address can be your current address; it can also be your parents' address or your partner's address.

Only fill out a "Permanent Address" if different from "Current Address".

Street address Apt
City
Province
Country
Postal code

(example: H2H 2G5) Click here if you don't know your Postal Code
Telephone at this address (incl. area code)
(example: 514-931-3526)

Parents' / Guardians' / Emergency Contact Information

Parent/Emergency Contact 1

First name
Last name
E-mail address
Cell phone number
(example: 514-931-3526)
Phone Work Extension
(example: 514-931-3526)

Only fill out if the address below is different from "Permanent Address".

Street address Apt
City
Province
Country
Postal code
Telephone at this address (incl. area code)
(example: 514-931-3526)
Relation with this person

Parent/Emergency Contact 2

First name
Last name
E-mail address
Cell phone number
(example: 514-931-3526)
Phone Work Extension

Please fill out address of Parent 2 if different from Parent 1 address

Street address Apt
City
Province
Country
Postal code
Telephone at this address (incl. area code)
(example: 514-931-3526)
Relation with this person

Socio-demographic information

The following information is collected for statistical purposes only

What is your family's approximate yearly income?
Current studies
If you study part-time or full-time, please complete the following:
Name of university
College, factulty or department
Name of program
Major
Minor
What year did you start?
What year are you in?
When do you expect to complete your program?
Current work
I am indigenous
Name of indigenous community
I have lived in my indigenous community in the last year
My community is
I am a member of a visible minority
I have a disability
Please specify