Predicted GCE Advanced Level Grades

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

Students completing General Certificate of Education (GCE or IGCE), may qualify for admission based on their predicted results. If you think you may qualify for admission based on your GCE results, please have your school counsellor or principal complete and submit this form.

Note: Please include all final AS-level results if AS-level exams have been completed to date.

GCE Advanced Level Results

Subject Level
(A or AS)
Predicted Grade
Final Grade Expected Month/Year
of Completion

GCSE Ordinary Level Results

SUBJECT O Level Final Grade Month/Year Taken

Counsellor/Principal Name:
Official School Email Address:

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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: