Application and Contract for Year 2010 & 2011 Courses

 NOTE: Please print in ink

Name: Last ___________________________ First ___________________ Middle Initial ____________

Address	_____________________________	SIN #	______________________________
	_____________________________	Age	______________________________
	_____________________________	Sex	______________________________
	_____________________________	D.O.B	______________________________
Phone	_____________________________

Dates	2010	August 24th – November 13
Dates	2011	August 9^th - October 30th

*(Circle One)

Email Address:______________________________

EMERGENCY CONTACT:

Phone:_________________________ Name:________________________________

The Private Career Colleges Act 2005 is prohibited by law from guaranteeing a position to any student or prospective student, and the contract is subject to the regulations made there under, and where a student has contracted for a course of instruction and gives notice to the private vocational school of his intentions to cancel the contract, the private vocational school is entitled to retain the fee and a portion of the fees for the whole course of instruction as provided for by sections 24--33 of the regulations made under the Private Career Colleges Act 2005.

Application fee should be sent along with application to hold a position. Photocopies of C.P.R., First Aid, SCUBA Certification and Diving Medical must be received prior to the start date, along with proof of grade 12 or equivalent.

Category "1" Commercial Diver 12 week course. Cost: $18,200 Canadian Dollars

 All statements are true to the best of my knowledge./Providing false information may lead to expulsion

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Signature	Date