4. Have you failed or dropped any courses in your program?
If so, please list _________________________________________________________________
______________________________________________________________________________
5. Have you attended any other post-secondary institutions prior to coming to this college?
Yes 
No
No If yes, please give details: _________________________________________________________
6. Were you registered with the Special Needs Office at that institution?
Yes
No
No 7. If yes, did you receive any accommodations (e.g. extra time for exams)?
Yes
No
No If yes, please specify: ____________________________________________________________
Previous Academic History
(attach transcripts where available)
8. Please list the schools you have attended: (Elementary, Secondary, Specialized, Adult Ed.)
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
9. What was the highest grade that you completed? _________________________________
10. What grades, if any, did you repeat? ___________________________________________
11. Did you receive a Secondary School Diploma?
Yes
No
No
12. What type of courses did you take at secondary school? ____________________________
____________________________________________________________________________
(Advanced/General/Basic, University/College/Mixed/Workplace)
(please attach high school transcripts)
