international registration/application form (pdf, 1.98 mb)

INTERNATIONAL APPLICATION FORM International Application #______________ (office use only)

PRIMARY INFORMATION

Date of Birth: Month

First Name

Mr. Mrs. Ms.

Female Male

Second Name

Day Year

PERMANENT ADDRESS INFORMATION

Street

Country

Last Name

State

Code

Country of Citizenship

COUNTRY AND LANGUAGE

English French OtherFirst language (basis for admission consideration):

If other, please specify

Secondary school graduate or equivalent Please e-mail transcripts with your application. You must bring original or certified/notarized copies with you at the time of registration.College/University studies.

Yes No

ADDITIONAL ACADEMIC INFORMATION

Have you written the TOEFL? (550 paper and 213 computer based; 79 - 1BT)

If Yes, indicate the date it was written TOEFL Score

If Yes, indicate the date it was writtenNoYesHave you written the IELTS? (6.0 - no band score less than 5.5 accepted. For graduate programs 6.5 no band score less than 5.5)

Score:

Listening Reading Writing Speaking

Overall

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APPLYING TO NORTHERN? 1. Complete this form. 2. Remember to sign and date this application (Page 3). 3. Fax the form to 705.235.7279 or email to: [email protected] 4. Mail the original to:

Northern College Admissions International Office

P.O. Box 3211 Timmins, ON P4N 8R6

A $100 application fee is required to process your application and is payable by credit card or wire transfer (details on last page).

E-mail Address

Home Work

NumberCity CodeCountry Code

TELEPHONE CONTACT INFORMATION

(Please have your score sheet sent to us.)


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1. Program

PROGRAM SELECTION (In order of preference)

Length

Start Date

Start Date

Length

2. Program

Start Date

Length

3. Program

Have you attended school or college in Canada before?

If Yes, indicate the date you attended and where:

NoYes

Program

School address

School attended

Date attended

Date attendedProgram

School address

School attended

Date attendedProgram

School address

School attended

FUTURE EDUCATION AND CAREER GOALSDo you plan to complete a diploma program and go on to University?

Yes No

NoYes

Are you planning to work in Canada for one or more years after graduation (as permitted by Immigration Canada)?

Freedom of Information and Protection of Individual Privacy Act: The information on this form is collected under the legal authority of the Ministry of Colleges and Universities Act, R.S.O. 1980, Chapter 272, S.S.,: R.R.O. 1980, Regulation 640. The information is used for administration and statistical purposes of Northern College and/or the Ministries and Agencies of the Government of Ontario and the Government of Canada. For Further information, please contact Student Services, Northern College, P.O. Box 3211, Timmins, ON, P4N 8R6. I certify that the above information is true and complete. I understand that any false or incomplete information submitted in support of my application may invalidate my application. I have read the Freedom of Information and Protection of Individual Privacy Statement.

AUTHORIZATION

DateSignature

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Pursuant to the Freedom and Protection of Individual Privacy Act, I hereby authorize Northern College to release any and all information related to any and all aspects of my application for admission, acceptance, fees or program of studies to the person whose name and address appears below. I certify that the person named is my selected representative and has my agreement to access and use this information to assist me to successfully register and access a program at Northern College. I authorize information release to my contact in Canada:

INFORMATION RELEASE

Contact's Name

Area Code

CONTACT'S TELEPHONE INFORMATION

Phone Number

E-Mail Address

DateSignature of Applicant


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First Name

NORTHERN COLLEGE TUITION FEE PAYMENT/REGISTRATION FORM


STUDENT INFORMATION

Last Name

Application Number (see top of the page)

Amount of Payment

Cardholder's Name

Expiry Date

Credit Card Number

Application Payment Information

VISA or MasterCard Wire Transfer

VISA or MasterCard Information

Cardholder's Signature

The following information will be required for a wire transfer: Bank: Royal Bank of Canada Address: 38 Pine Street North, Timmins, ON Canada P4N 6K6 Bank#: 003 Transit #: 05112 Account #: 000-013-3 Swift Code: ROYCCAT2 Please ensure the College is notified when the transfer has been processed and the amount of the transfer as it will be important to verify the deposit and to process the payment on your account. Please note that should a refund be required, the cost of the wire transfer will be added to the non-refundable $2500 administration fee (generally the wire transfer fee charged by the bank is $50). Please contact the International Office at [email protected] to confirm that the wire transfer has been sent. REFUND POLICY Please see the following web site page for more information http://www.northernc.on.ca/international

http://www.northernc.on.ca/international

international registration/application form (pdf, 1.98 mb)

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