Undergraduate Studies Application for Admission


(Canadian citizens and permanent residents only)

Requested Session:  *  
Student Applicant Information

If you have applied to Brock University before, please provide your Brock Student Number:   
Surname *   Former Surname(s)
First/Given Name *   Chosen Name
Middle Name(s)
Date Of Birth (yyyy/mm/dd)
Ontario Education Number  
First Generation Question
Have either of your parents/guardians attended college or university? 
Student Citizenship & Language Information
Current Status in Canada *  
Date of Entry
First Language
If "Other", please specify:
Student Contact Information
Student E-mail Address *  
Country *  
Address 1 *  
Address 2
Address 3
City *  
Postal Code or Zip Code
Fax Number
Cell Phone Number
Alternate Phone Number
Permanent Phone Number
Enter the code shown: