INTERNATONAL STUDENT APPLICATION FORM Family Name Middle Name First Name Birthdate Address City State/Province Zip/Postal Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Email Address Phone Number Civil Status Single Married Divorced Separated Others Husband's Name Husband's Occupation Can he support you financially? Yes No Wife's Name Wife's Occupation Can she support you financially? Yes No Parents' Name Parents' Occupation Can your parents support you financially? Yes No Elementary High School College or University College or University Program Taken Other certificates obtained Masteral Program PhD Program Applicants background or employment history for at least 10 years Can you obtain an HR letter from your current job? Yes No Will the company you are working, able to support your endeavor to study abroad? Yes No Do you own Business or do you parents own a business? Yes No Name of business Nature of business Dates and duration of business Do you have relatives that can support you financially? Yes No Name Work Status in the country they are working Do you have personal properties under your name or parents name or husbands Yes No Name Can you provide property titles ? Yes No What program would you like to get into? Narratives if you would like to apply into a program that is totally different from your current Job? Why did you choose Canada, your study destination? How would you like to be impacted by pursuing Canadian Education? What is your ultimate goal after taking the program? File Upload Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 2.097152MB File Upload (Resume) Drop a file here or click to upload Choose File Maximum upload size: 2.097152MB How did you know about "PCI"? Website Facebook PCI career consultant If you came to know about "PCI" through a website, please identify the website If you came to know about "PCI" via Facebook, please identify the Fanpage or the Facebook ID If you came to know about "PCI" through a PCI Career Consultant, please identify the consultant Note: a. We DO NOT ALLOW agents collect payments from the student applicants. b. Application will not be processed unless agents or career consultants are specified.