College of New Caledonia Application Form
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International Student Application for Admission Form CNC Student Number: PROGRAM APPLIED FOR Name of Program you are applying for: ESL ESL + University Transfer ESL + Business Certificate/Diploma University Transfer Business Certificate/Diploma Other (See attached cover sheet for list of available programs) ___________________ Last/Family Name: Start Date: September January May Year: STUDENT INFORMATION First Name: Birthdate: _________/_________/_________ Year Month Day Gender: Male Female Citizenship (Country) ___________________________ YOUR PERMANENT ADDRESS (Home Country) Street Address: City: District/State: Country: Postal Code: Email: Phone or Cell Phone: CURRENT MAILING ADDRESS (ONLY COMPLETE IF YOU ARE CURRENTLY LIVING IN CANADA) Street Address: City: Phone or Cell Phone: Province/Postal Code: International Education Department 3330 22nd Avenue, Prince George, British Columbia V2N 1P8 CANADA Telephone: (250)561-5857 Fax: (250)561-5856 Email: [email protected] Website: www.cnc.bc.ca/ined Email: Phone or Cell Phone: Email: AGENT MAILING ADDRESS AND INFORMATION (ONLY COMPLETE IF YOU HAVE AN AGENT) Name of Agent or Company Name: EMERGENCY CONTACT Street Address: City: Postal Code: MAIL MY LETTER OF ACCEPTANCE TO: My Permanent Address My Agent Province/District/State Country: Email: Phone or Cell Phone: Relationship to You: (Example your Mother or Father) Name of Emergency Contact Application Fee: $125 (Non Refundable)
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Transcript of College of New Caledonia Application Form
International Student Application for Admission Form
CNC Student Number:
PROGRAM APPLIED FOR
Name of Program you are applying for:
ESL ESL + University Transfer ESL + Business Certificate/Diploma University Transfer
Business Certificate/Diploma Other (See attached cover sheet for list of available programs) ___________________
Last/Family Name:
Start Date: September January May Year:
STUDENT INFORMATION
First Name:
Birthdate: _________/_________/_________
Year Month Day
Gender: Male Female
Citizenship (Country) ___________________________
YOUR PERMANENT ADDRESS (Home Country)
Street Address:
City: District/State: Country:
Postal Code: Email: Phone or Cell Phone:
CURRENT MAILING ADDRESS (ONLY COMPLETE IF YOU ARE CURRENTLY LIVING IN CANADA)
Street Address:
City:
Phone or Cell Phone:
Province/Postal Code:
International Education Department 3330 22nd Avenue, Prince George, British Columbia V2N 1P8 CANADA Telephone: (250)561-5857 Fax: (250)561-5856 Email: [email protected] Website: www.cnc.bc.ca/ined
Email:
Phone or Cell Phone: Email:
AGENT MAILING ADDRESS AND INFORMATION (ONLY COMPLETE IF YOU HAVE AN AGENT)
Name of Agent or Company Name:
EMERGENCY CONTACT
Street Address:
City:
Postal Code:
MAIL MY LETTER OF ACCEPTANCE TO: My Permanent Address My Agent
Province/District/State Country:
Email: Phone or Cell Phone:
Relationship to You: (Example your Mother or Father)
Name of Emergency Contact
Application Fee: $125 (Non Refundable)
PREVIOUS EDUCATION (For all programs other than ESL, official transcripts are required)
Last Secondary School Attended: Grade Completed:
Last College of University Attended: Program Completed:
ESL Credentials: TOEFL IELTS OFFICIAL DOCUMENTS MUST BE INCLUDED WITH THIS
APPLICATION FOR ALL PROGRAMS OTHER THAN ESL
Score __________ Score ____________
Year:
Year:
ACCOMMODATIONS
Homestay Complete Homestay Application Form (included in this package)
Private Accommodations (only check this box if you have a relative or friend in Prince George)
HOW DID YOU HEAR ABOUT CNC?
PLEASE CIRCLE ONE: FAIR (Name of Fair ____________________) AGENT STUDENT
MAGAZINE ADVERTISEMENT (Which one? ______________________________)
CNC WEBSITE OTHER WEBSITE (Which one? _____________________)
OTHER _______________________________________
METHOD OF PAYMENT ($125.00 NON-REFUNDABLE IN CANADIAN FUNDS IS REQUIRED AT TIME OF APPLICATION)
Credit Card Visa OR Mastercard Card Number ________________________________________
Expiry Date ____/_______
Name on Card ____________________________ Cardholder Signature __________________________________
Bank Draft/Cheque Wire Transfer (Attach copy of banking details)
RELEASE OF INFORMATION
I give permission for the College of New Caledonia to release my information or contact my agent, or the person I have named on my application form as an Emergency Contact in situations the College decides are urgent, including, for example, health problems, safety concerns and wellness.
Further, I give permission to allow the College of New Caledonia International Education staff to provide information regarding my academic progress, attendance and grades to my agent, or the person I have named on my application form as an Emergency Contact.
I also grant permission for the College of New Caledonia to use my written comments, or photographs of myself, either in a group or individually taken during special events and activities, for the purpose of promoting the College of New Caledonia.
The information on this form is collected under the Authority of the Freedom of Information Protection of Privacy Act (Part 3, Division 1, Sec. 267 c). The information provided will be used in accordance with the Act (Part 3, Division 2, Sec. 32 (a)). If you have any questions about the collection and use of this information, contact the Freedom of Information Coordinator, College of New Caledonia.
I hereby accept and agree to the terms and conditions listed above:
Signature of Student Applicant ________________________________________ Date: ______________________________
IMMIGRATION DETAILS
Passport # _____________________ Passport Issue Date ___________________ Passport End Date __________________
Country of Issue ________________________________
Do you have a Study Permit? No Yes If yes: Study Permit # _____________ Permit Start Date _____________
Permit End Date _____________
Country:
Country:
