Please answer all questions as completely as possible.

I am applying for:
I am applying for Grade: 9 10 11 12
I will be a: New Student Re-entry Student
I will be: Living in a student residence
Living at home with a parent/guardian
Living in alternate housing
Have you applied to attend BCA before? Yes No

Prefix: Mr   Ms
Legal First Name: Legal Last Name:
Middle Name: Permanent Mailing Address:
City: Province/State
Postal/Zip Code: Country
Home Phone -- Cell Phone --
Student's Email Address:
Date of Birth (mm/dd/yy):
Citizenship: Canadian US Other: 

Aboriginal Ancestry is determined by reference to the Canadian Constitution Act of 1982 and includes Indian, Métis and Inuit persons of Canada as well as persons who are accepted by one of the Aboriginal peoples of Saskatchewan as a member of their community.
Leave this blank if it does not apply.

What was the main factor that influenced you to apply to BCA? Have you visited the campus of BCA? Yes No
If Yes, when or for what event did you visit the campus?    

Father's Name: Address:  Same as above or: 
Phone Number:    
Mother's Name: Address:  Same as above or: 
Phone Number:    
Parent's Email Address:    
Have you had any relatives attend BCA, Briercrest College or Briercrest Seminary?
Mother Father Brother(s)/Sister(s) Cousin(s) Aunt(s)/Uncle(s) Grandparent(s)

With whom do you live?
Who has legal custody of you?

Do you presently attend church? Yes No If Yes, what church?
Denomination of church: Pastor's name:
Church address: City:
Province/State: Postal/Zip Code:
Phone Number: Email Address:
How long have you attended this church? How often to you attend?
What events or activities are you involved in at this church?
Do your parents attend the same church?   Yes No
Do your parents attend regularly?   Yes No


What schools have you attended? (Mandatory)

Grade Name of School(s) Type(s) City, Province/State Dates
8 Public Private Home
9 Public Private Home
10 Public Private Home
11 Public Private Home
12 Public Private Home
Have you ever repeated a grade? Yes No If yes, which grade?
Have you ever been expelled /
dismissed from school?
Yes No If yes, for how long?
State circumstances:


The application fees are as follows:

*Note that Canadian citizens living abroad are considered international students

How will you be paying?: