Application

Name: Carlton Trail College
Price range: $

*Required Field

What Program Are You Applying For?

Program Name

Code

Type of Program (if known)

Program Location

Coordinating Office

Academic Start Month and Year

Personal Information

First Name *

Last Name *

Middle Name(s)

Gender *

Birthdate (Select YEAR > MONTH > DATE) *

P.O. Box # or Street Mailing Address *

Town/City *

Province *

Postal Code *

Primary Phone Number xxx-xxx-xxxx *

Email Address *

Do you consider yourself a visible minority? (The Employment Equity Act defines visible minorities as "persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour.")

Emergency Contact

This person will be contacted if we cannot reach you by way of your other contact information.

Emergency Contact Name

Emergency Contact Primary Phone Number xxx-xxx-xxxx

Emergency Contact Email Address

Education and Employment

Employment Status

If yes, name of employer?

Previous Education

What is your citizenship status? *

Citizenship & Residency

Arrival Date in Canada (Select YEAR > MONTH > DATE) *

What country did you immigrate from?

Client ID Number (as shown on immigration documents)

Visa or Permit Expiry Date (Select YEAR > MONTH > DATE)

Program and Language Information

Course Name *

Course Location

Course Start Month and Year

Code

What is your preference for Class?

What is your main reason for seeking English language training? (Choose one.) *

Have you had English classes before?

If yes, where?

What is your first language?

Have you had an English language assessment?

How did you FIRST become aware of THIS program or course? *

Would you like to receive promotional information about Carlton Trail College's programs and events via email?

Authorization and Consents

The information on this form is collected under the legal authority of the Regional Colleges Act 1998 and the Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP). The information is used for administrative and statistical purposes by Carlton Trail College and/or Ministries and Agencies of the Saskatchewan Government and the Government of Canada. If you have any questions about the collection or use of this information, please contact the Carlton Trail College Privacy Officer at 1.800.667.2623.

Carlton Trail College reserves the right to revise or cancel programs and courses, revise policies and procedures, and alter tuition, fees and other charges as deemed necessary without notice.

By submitting this application form, I hereby acknowledge, authorize and consent to the following:

I consent to Carlton Trail College using and releasing my personal information to any person, agency, or government agency such as Immigration, Refugees and Citizenship Canada and the Ministry of Immigration and Career Training, as may be necessary to support my English language training and the funding and delivery of English language programming.

I agree to abide by the rules and regulations of Carlton Trail College, including adhering to program related attendance policies.

I hereby certify that all of the information provided is true and complete. I understand that false information may result in the cancellation of my status as a registered student.

Name *

Date (Select YEAR > MONTH > DATE) *

Please enter the text below. *

First Name