Academic Planning Registration Form

Please complete this form to register.

I am the

Your First Name

Your Last Name

Email Address

Home Phone

Cell Phone

Country

Country where you are currently living.

Street Address

Address Line 2

City

Province/Territory

State

State/Province

Postal Code/Zip Code

Career Path / Career Interest:

Undergraduate Path: Applying to:

Business Path: Applying to:

Dentistry Path: Applying to:

Law Path: Applying to:

Medicine Path: Applying to:

Nursing Path: Applying to:

Optometry Path: Applying to:

Pharmacy Path: Applying to:

Physiotherapy Path: Applying to:

Other (Please Describe):

Current Academic Level (as of 2018-2019):

Graduation Year

Name of High School

High School - Graduation Year

Undergraduate Program

Undergraduate Program - Where is the University/College you are currently attending located?

Undergraduate Program - In which province/territory?

Undergraduate Program - In which state?

Undergrad - Name of Current University/College - Saskatchewan

Undergrad - Name of Current University/College - Quebec

Undergrad - Name of Current University/College - Manitoba

Undergrad - Name of Current University/College - Prince Edward Island

Undergrad - Name of Current University/College - British Columbia

Undergrad - Name of Current University/College - Ontario

Undergrad - Name of Current University/College - Nova Scotia

Undergrad - Name of Current University/College - Newfoundland

Undergrad - Name of Current University/College - New Brunswick

Undergrad - Name of Current University/College - Alberta

Undergrad - Please state the university/college you are attending:

Undergraduate - Faculty and Major

Undergraduate Program - Graduation Year

Graduate School

Graduate School (GS) - Where is the University/College you are currently attending located?

Graduate School (GS) - In which province / territory?

Graduate Program - In which state?

GS - Name of Current University/College - Saskatchewan

GS - Name of Current University/College - Quebec

GS - Name of Current University/College - Manitoba

GS - Name of Current University/College - Prince Edward Island

GS - Name of Current University/College - British Columbia

GS - Name of Current University/College - Ontario

GS - Name of Current University/College - Nova Scotia

GS - Name of Current University/College - Newfoundland

GS - Name of Current University/College - New Brunswick

GS - Name of Current University/College - Alberta

GS - Please state the university/college you are attending:

Graduate Program - Faculty and Major

Graduate Program - Graduation Year

Professional School

Professional School (PS) - Where is the University/College you are currently attending located?

Professional School (PS) - In which province / territory?

PS - In which state?

PS - Name of Current University/College - Saskatchewan

PS - Name of Current University/College - Quebec

PS - Name of Current University/College - Manitoba

PS - Name of Current University/College - Prince Edward Island

PS - Name of Current University/College - British Columbia

PS - Name of Current University/College - Ontario

PS - Name of Current University/College - Nova Scotia

PS - Name of Current University/College - Newfoundland

PS - Name of Current University/College - New Brunswick

PS - Name of Current University/College - Alberta

PS - Please state the university/college you are attending:

Professional School Program - Graduation Year

I am interested in booking an:

Academic Planning Session - $200 + tax

I am interested in discussing (check all that apply):

Profile-Building StrategiesUniversity SelectionExtracurricular, Volunteer, Work ActivitiesGuidance on Course Selection

If applicable, please list the schools/organization(s) that are of interest to you at this time:

Please indicate how you wish to have your academic planning session conducted. Please choose only one option for each of first choice and second choice:

Face-to-face at our Toronto office (located at Yonge and Sheppard)

By Phone/Video Conference

When you would like to schedule your Academic Planning Session? Please provide us with several blocks of time/dates that work for you. Please be as specific as you can in terms of your availability. If you want to request a particular date(s), please indicate this as well. Please also ensure that the phone number field above has been completed so that we can call you.

Additional Information: Are there are any documents that you would like to discuss during your academic planning session? You will have a chance to upload your document(s) once you submit this form. Once you press "Submit", a link to "Upload Document" will be provided. Examples of documents you may wish to include are: Current Draft of Your Résumé, Transcript, etc.

Do you have documents that you would like to discuss with us?

If you have any concerns or comments for Astroff Consultants (e.g., specific questions at this time), please feel free to use the space below to provide details:

How did you hear about us?

What is the name of the university student club?

Name of referrer:

If you have a coupon, gift certificate or are entitled to a promotional discount, please provide details (including your voucher number if applicable):

Parent / Guardian Information

Please provide the contact information for your parent/guardian so we can obtain his/her consent to register with us.

Parent / Guardian First Name

Parent / Guardian Last Name

Parent / Guardian's Email Address

I have read and agree to Astroff's Terms and Conditions and Privacy Policy.

Yes! I'd like Astroff to provide me with tips and strategies to maximize my preparation time and improve my profile, as well as information on products, services and promotional offers. I agree that Astroff may contact me by email, telephone and/or text message. I understand that I can unsubscribe at any time.

Contact Information

Academic Planning Registration Form

Please complete this form to register.

Reach your potential. Achieve new heights.

Reach your potential. Achieve new heights.