Phone: 780.492.

3113
Fax: 780.492.7172
Web: ualberta.ca/admissions/undergraduate

APPLICATION FOR ADMISSION

FOR UNDERGRADUATE STUDIES

BEFORE YOU BEGIN: IS THIS FORM FOR YOU?

Apply online!
We strongly encourage you to apply online, if possible. It’s fast, secure, and mobile-friendly!
uab.ca/apply
This paper application form is intended for applicants who:
Are not able to complete the online application
Are not able to pay the online application fee
Have been granted a special exemption or extension by their faculty and require authorization

Applying to one of these programs?

Doctor of Medicine
Doctor of Dental Surgery
Dental Hygiene Diploma
Do not use this form. Please contact the department.

Applying to Campus Saint-Jean?

You may use the French version of the application form (demande d’admission) available at Campus Saint-Jean or at uab.ca/apply

SUBMISSION INFORMATION

Submit your application to:

Office of the Registrar
Administration Building
University of Alberta
Edmonton, AB T6G 2M7
Fax: 1.780.492.7172
Please enclose payment with your application. See next page.

Protection of Privacy
The personal information requested on this form is collected under the authority of the Alberta Post‑Secondary Learning Act and the Alberta Freedom of Information and Protection of Privacy Act for
authorized purposes including admission and registration; administration of student records; consideration for scholarships and awards; and provision of student services. Personal information
may be disclosed to academic and administrative units according to University policy; alumni relations and fundraising upon graduation; university planning and research in accordance with federal
and provincial legislated reporting requirements; information sharing agreements; and to contracted service providers as required. For further information on the use and disclosure of personal
information, please visit the University Calendar: uab.ca/calendar > University Regulations and Information for Students > Student Records > Collection of Personal Information, the Information and Privacy
Office (ipo.ualberta.ca), or contact the Office of the Registrar at 780-492-3113.
PAYMENT

Application Fee
Please enclose payment with your application. Cheque, money order, and credit card are accepted. Do not enclose cash. We will not begin processing
your application until full payment has been received.
This application fee is non-refundable.

Have you ever attended the University of Alberta or Augustana in the past?
 No If no, enclose the required CAD $125 nonrefundable application fee.
 Yes If yes, enclose the required CAD $75 nonrefundable application fee.

Payment method:

  Cheque or money order  Make cheques payable to the University of Alberta.

  Credit card  Mastercard, Visa, American Express, and Discover are accepted.

Credit Card Holder’s Name (as it appears on the card)

Card Holder’s Signature

X
Credit Card Number Expiry Date

M M Y Y Y Y
1. PERSONAL INFORMATION Office Use Only Office ID
Receipt Stamp below

Please print clearly. If your writing is illegible, your application processing could be delayed.

NAME

Please print your name

STUDENT STATUS

Former or Current UAlberta Student Status

Have you ever registered or taken courses at the University of Alberta? UAlberta Student ID

 Yes Please provide your seven-digit UAlberta Student ID.

 No

INTENDED START DATE

Start Date Status

Most programs only admit to Fall Term. Visit the University Calendar: uab.ca/calendar > Undergraduate Application Deadlines for Admission and Readmission.

What term are you applying to? Start Date

  Fall / Winter (September–April)

  Spring / Summer (May–August) M M Y Y Y Y

Student Status
What is your intended student status?
  Degree or Diploma Student­
Students working toward a degree or diploma.

  Special Student
Students applying for admission to a faculty to take course(s) for credit, but not working toward a degree. Most Special Students will have a degree and/or
wish to take courses for professional development.

  Visiting Student
Students applying for admission to a faculty to take course(s) for credit toward a degree from another institution. A “Letter of Permission” from the other
institution is required.

  Open Studies
Part-time students taking courses for credit without following a degree or diploma program. Please visit the University Calendar: uab.ca/calendar
> Undergraduate Programs > Open Studies for information regarding Open Studies programs and policies.

APPLICANT INFORMATION

Legal Name
Use your legal name as shown on your birth certificate, passport, marriage certificate, or Immigration and Citizenship Canada document.
This name will appear on your university record, as well as on your degree or diploma parchment upon graduation.
If any of your personal information changes, please notify the Office of the Registrar or update it on Bear Tracks.

Last Name / Family Name First Name / Given Name Middle Name(s)  Do not use initials.

Former Name  If applicable. Date of Birth   Male

 Female
M M D D Y Y Y Y   Another / Prefer not to disclose
Country of Birth Country of Citizenship First Language

APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  1

1. PERSONAL INFORMATION (CONTINUED)

APPLICANT INFORMATION (CONTINUED)

Correspondence Addresses
Street Address, Apartment Number, Box Number

City or Town and Province Country Postal Code

(Area Code) Home Telephone (Area Code) Business/Cell Phone Number

Your personal email address will be used to communicate to you until you are assigned a UAlberta email account. Subsequent communications
will be sent to your UAlberta email address. It is your responsibility to check your UAlberta email frequently. For more information, visit the University
Calendar: uab.ca/calendar > University Regulations and Information for Students > Electronic Communication Policy for Students and Applicants.

Personal Email Address

Hometown
What do you consider to be your hometown, if different from above? (This information is used to track student mobility).

City or Town Province Country Postal Code

Citizenship Status in Canada

Proof may be required.

Are you a Canadian citizen?     Yes­    No  If no, please indicate your citizenship status:

­   I became a Permanent Resident  Please indicate the effective date. Effective Date
  I have applied or will be applying for a study permit
  Other (specify) M M D D Y Y Y Y

Resident of Alberta
You may qualify as an Alberta resident if you are a Canadian Citizen or Permanent Resident (Landed Immigrant) and you have continuously lived in Alberta,
the Northwest Territories, the Yukon Territory, or Nunavut for at least one year immediately prior to the first day of classes of the term to which you are applying.
The one-year residence period shall not be considered broken if the Admissions Committee is satisfied that the applicant was temporarily out of Alberta on
vacation, in short-term employment, or as a full-time student.

Are you a resident of Alberta?­   Yes If yes, give the month and year you began continuous residency, even if it is your birth date.­  Beginning Date

 No M M Y Y Y Y

Canadian Indigenous Applicants

You are encouraged to self-declare if you are Indigenous according to the Canadian Constitution Act of 1982 (i.e. First Nations, Métis, or Inuit) as well as
recent amendments to the Indian Act. By declaring your status, you will aid in the development of new services and events for Indigenous students at the
University of Alberta. Please note that some programs require proof of Indigenous identity for admission purposes. Please visit the University Calendar:
uab.ca/calendar > Undergraduate Admission > Admission of Aboriginal Applicants for more information.

Do you wish to declare that you are of Canadian Indigenous ancestry?

  Yes  If yes, please specify:   Métis
  No   Inuit
  First Nations of Canada:       Non-Status     Status     Bill C-31     Bill C-3

Emergency Contact
Name Relationship (Area Code) Home Telephone (Area Code) Business/Cell Phone Number

APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  2

2. ACADEMIC PROGRAMS

PROGRAM CHOICES

New Applicants to the University of Alberta Applying to Augustana?

Indicate up to two program choices, in preferential order. If you are not
eligible for your first program choice, you will be considered for your
second program choice. Where applicable, you may be considered for
alternate programs other than those you select.
Current and Previous UAlberta Students
Please enter only one program choice per application. If you wish
to apply to multiple programs, you will need to submit multiple
applications and pay the application fee each time.
If you wish to attend Augustana Campus, in Camrose, AB, be sure to
select Augustana as your faculty of choice.
Applying to Campus Saint-Jean?
If you wish to take courses at Campus Saint-Jean, in Edmonton,
be sure to indicate Campus Saint-Jean as your Faculty of choice.
Applying to Physical Education (BKin / BEd), Arts (BMus / BEd)
or Native Studies (BA / BEd)?
Applicants must enter a route: Elementary or Secondary.

Program Choices
Please specify all relevant program details. For information about programs and requirements, see the Viewbook or visit ualberta.ca/admissions/undergraduate

PRIORITY FACULTY PROGRAM HONORS / ROUTE / SPECIALIZATION MAJOR MINOR

1
2
ADDITIONAL PROGRAM DETAILS FOR APPLICANTS TO:

Faculty of Agricultural, Life and Environmental Sciences

Are you applying to Pre-Veterinary Medicine?
  BSc in Animal Health (any major)
  BSc in Agriculture (Animal Science major)

Faculty of Education
Are you applying to a collaborative off-campus program? If so, indicate location.
  ATEP     GPRC     Keyano     Red Deer

Faculty of Engineering
Will you be taking first-year courses in French at Campus Saint-Jean?
  Yes     No

Faculty of Nursing
Are you applying to a collaborative off-campus program? If so, indicate location.
  GPRC     Keyano     Red Deer     After Degree (Camrose)

Faculty of Kinesiology, Sport, and Recreation

Are you applying from a Physical Education program at an off-campus location? If so, indicate location.
  GMU     GPRC     Red Deer

APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  3

 3. ACADEMIC HISTORY
A complete listing of secondary and postsecondary education is required. If you attend another institution after completing this form, notify the
Office of the Registrar immediately in writing.

(A) English Language Proficiency

All applicants, including Canadian applicants, must meet the English Language Proficiency (ELP) requirement in order to be admissible. Please indicate the
number of full-time years of formal education you have had at an institution where the primary language of instruction was English, excluding ESL courses.

Years

(B) Educational and English Language Proficiency Tests

e.g. CAEL, IELTS, LSAT, MELAB, SAT, TOEFL, TSE
If applicable, enter the name and date of last writing or date the test will be written. Attach additional sheets if necessary.

NAME OF TEST DATE SCORE

M M Y Y Y Y
M M Y Y Y Y
M M Y Y Y Y
M M Y Y Y Y
M M Y Y Y Y
M M Y Y Y Y
Law Applicants: please enter your LSAC number if available. If you have written IELTS please enter your Test Report Form (TRF) number.

LSAC Number TRF Number

C) IB/AP

Have you written or will you write any International Baccalaureate or Advanced Placement (College Board) examinations?
  Full IB     Partial IB     AP     Not Applicable  

D) Alberta Student Number

If you attended school in Alberta, you must provide your Alberta Student Number (ASN). To find your ASN, check your transcript or go to education.alberta.ca

Alberta Student Number

(E) Secondary Education (High School)

List all previous and current secondary institutions you have attended (Grade 10 through to Grade 12 or equivalent).

PROVINCE OR COUNTRY NAME OF INSTITUTION FROM TO LANGUAGE OF INSTRUCTION

M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y

Attach additional sheets if necessary APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  4
 3. ACADEMIC HISTORY (CONTINUED)

(F) Secondary Coursework

If you have already completed Grade 12, do not complete the following section and instead submit final, official transcripts.
If you have not completed Grade 12, please submit your available courses and marks using the form below. Your final, official transcripts will also be required.
If there is a discrepancy between your grades listed here and your final, official transcripts, your admission offer may be revoked.
Alberta high school students: Your final, official transcripts will be sent automatically via the ApplyAlberta system. (Some exceptions may apply.)
Outside of Alberta/Canada: You are responsible for ensuring that your final, official transcripts are sent to the university from the issuing institution or ministry.
Canadian high school courses: International high school courses:
List all Grade 11 and Grade 12 courses that you have completed as part Do not use the form below. Instead, attach copies of documents
of a Canadian high school curriculum, as well as your final marks for indicating your final marks in any Grade 11 and Grade 12 courses
each course. Also list any Grade 12 subjects that you are currently you have completed as part of an international high school curriculum.
taking or are planning to take. If you are taking a linear or full-year Acceptable documents include transcripts, school reports, report cards,
course, you can enter a mid-year mark, as long as it reflects at least and/or examination results. If the language of your documents is not
50% of the course content. English or French, please provide copies of official translations as well.
Please enter at least six courses.

GRADE (Circle one) COURSE MARK (Percent) COURSE LENGTH (Circle one) COMPLETED PLAN TO TAKE IN PROGRESS

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

11 / 12 Half-year / Full-year

(G) Previous and Current Post-secondary Education

Are you attending, or have you attended, any post-secondary institutions, including the University of Alberta?
List all institutions you have attended, regardless of the length of attendance, whether or not courses were completed, or whether or not you believe
the record will have a bearing on admission or transfer credit. Withholding information in regard to this application is a serious offence and may result
in the cancellation of your application and prosecution under the University’s Codes of Behaviour.
If you attend any institution after submitting this application, notify the Office of the Registrar in writing or by email immediately.

PROVINCE OR COUNTRY NAME OF INSTITUTION FROM TO LANGUAGE OF INSTRUCTION

M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y
M M Y Y Y Y M M Y Y Y Y

Attach additional sheets if necessary APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  5
3. ACADEMIC HISTORY (CONTINUED)

(H) Post-secondary Degree

Will you have a university degree by the time you wish to begin attendance here? Date Received

 Yes If yes, specify institution, degree, and date received.

 No M M Y Y Y Y
Name of Institution Degree

4. AUTHORIZATION

ApplyAlberta Transcript Authorization

Through ApplyAlberta, the University of Alberta is able to obtain high school transcripts from Alberta Education and transcripts from certain participating
ApplyAlberta post-secondary institutions on behalf of applicants. Applicants do not have to pay for transcripts obtained through this service.
To authorize the University of Alberta to obtain your transcripts from participating ApplyAlberta institutions where required, please sign the transcript
authorization and provide your Alberta Student Number (ASN) in Section 3A above. For more information go to applyalberta.ca
If you did not attend a participating ApplyAlberta institution, you are responsible for requesting all required transcripts to be sent directly from the
issuing institutions you attended.

I understand that transcripts from institutions I have attended are required to support my application for admission to the University of Alberta. I
hereby authorize the University of Alberta to obtain transcripts from certain participating ApplyAlberta institutions on my behalf, where required,
and I authorize the University to obtain or verify my Alberta Student Number, as required.

Applicant’s Signature

5. DECLARATION

Declaration

I certify that the information in this application is true and complete in all respects and that I have withheld no information. I understand that
misrepresentation, falsification of documents, or withholding of requested information regarding this application are serious offences and may result
in the cancellation of my application and prosecution under the University of Alberta’s Codes of Behaviour and/or the Criminal Code of Canada. By
this declaration I give my expressed consent to the disclosure of falsified information or misrepresentation to other post‑secondary institutions. I
agree, if admitted to the University of Alberta, to comply with the University regulations as stated in the University Calendar.

Applicant’s Signature Date of Application

X M M D D Y Y Y Y

Thank you for applying to the University of Alberta!

You will be notified via email when your payment has been received. Please continue to watch for emails regarding updates to your application.
You can also track the status of your application in Bear Tracks: uab.ca/beartracks
For more information visit ualberta.ca/admissions/undergraduate

APPLICATION FOR ADMISSION FOR UNDERGRADUATE STUDIES  |  6