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About You First Name Last Name

Date of Birth

Your Contact Details Email Retype Email Telephone Address City

Province

Postal Code

Which Campus are you interested in? Thunder Bay Orillia

What programs at Lakehead University interest you?

Currently Attending School Name School City

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Grade

What do you expect your final Grade 12 average to be?

Would you be interested in our International Exchange Program? Yes No Maybe

Contest Rules Yes, I accept the contest rules

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