Non-Graduated Adult Form

Legal Name

First Middle Last

Previous/Maiden Name:

Usual/Preferred Name:

Date of Birth

Did you graduate?

Are you a resident of BC?

Phone

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you have any grade 10,11 or 12 credits?

Nuu-Chah-nulth Community?

Will you be attending the EALC graduation ceremony?

Do you plan to attend college/university after you graduate?

Proof of Residency Upload

Max. file size: 2 GB.

Signature