Predicted International Baccalaureate (IB) Grades


Last Name or Surname: First name or Given Name:
Last Name or Surname is required.
Western Student Number: OUAC Reference Number:
OUAC reference number is required.

Students in the IB Diploma program may qualify for admission based on their predicted/final IB results. The Admissions Office will take into consideration the predicted grades in both individual subjects and additional points for the Extended Essay and Theory of Knowledge (TOK). If you are completing the IB Diploma program, please have your school counsellor or principal complete and submit this form. If you are not completing the full IB Diploma, please have your secondary school send an official transcript and relevant standardized tests to the Undergraduate Admissions Office.

Is this applicant registered in the full IB Diploma program?
Please make a selection.
Please indicate whether your school provides predicted Theory of Knowledge and Extended Essay Results. If 'yes' please ensure that the Diploma Points section below has been completed.
Please make a selection.
Subject Level
(HL or SL)
Predicted Grade
(1-7) please indicate if grade is final

Diploma Points: (Essay and TOK)
Predicted Total Points:

Counsellor/Principal Name:
Official School Email Address:

Please check the box!

The personal information on this form is collected under the authority of The University of Western Ontario Act 1982, as amended. To view the complete Personal Information Collection Notice visit the online Academic Calendar at: