Early Application Declaration

Submission deadline of this form for ALL EARLY ADMISSION schools (including UBC) is required no
later than September 30, 2017

Full name

SECTION A - EARLY ACTION/EARLY DECISION FOR US, UK MEDICAL/VETERINARIAN, OXFORD AND

CAMBRIDGE, IRISH UNIVERSITIES MEDICAL/DENTAL PROGRAMS
Please list, in chronological order by date ALL schools with deadlines before DECEMBER 15, 2017.

UCAS/
Early Action/
Common
Early
App/UCal/Atlantic
Decision?
Name of university or college & country Bridge Application Due Date
(unsure? See
(indicate
your
application process
counsellor)
you are using)

SECTION B - REFERENCES
For US applications 2 references are required. For UK and Irish applications only 1 reference is required and Ms. Livingston will
be the reference provider Ms. Livingston gather multiple teachers input for the writing of the UK and Irish reference.

Reference Name Reference Signature

Ref #1

Ref #2

______________________________________ _____________________________________
Parent/Guardian Signature Student Signature