Native Education and Training College
(1635958 ONTARIO INC)
248 Main Street West North Bay ON P1B 2T7
TOLL FREE 1-800-267-2577 Website: www.nativetc.com FAX 705-497-7839

Private Career College Enrollment Application

Name: _________________________________________                        Gender: M_____F______  

Address:     ________________________________________________________________________

                 
________________________________________________________________________  

Email:       _________________________________________________________________________

Telephone: (____)______________________   Date of Birth_______________________________

Program Name: ___________________________________________________________________   

Program Type:      Certificate ______Diploma_______

Tuition Fee: ______________       Application Fee: $ 100.00          Textbook Fee: ______________ 

Type of Funding: First Nation Ed Authority [   ]      Metis [   ]         Aboriginal HRDC   [   ]
                            Personal Payment Plan  [   ]
      First Nation  [   ]        OSAP/CSL   [   ]
                            Other   [   ]

Program Duration: ______________ Start Date: ________________End Date: __________________  

ACADEMIC BACKGROUND:

High School: _______________________________________________________________

Location: __________________________________________________________________

Last Grade Completed: ______    OSSD  [   ]  GED  [   ]  Ontario Basic Skills  [   ]  GAS  [   ]  

POST-SECONDARY EDUCATION:

College or University     ____________________________________________________________ 

Location        ___________________________________________________________________                           
Qualifications Obtained   ___________________________________________________________  

College or University     ____________________________________________________________ 

Location        ___________________________________________________________________                           
Qualifications Obtained   ___________________________________________________________  

The Native Education & Training College is prohibited by law from guaranteeing a position to any student or prospective student. This contract is subject to the Private Career College Act, and the regulations made thereunder. For information regarding cancellation of this contract, and refunds of monies paid, see sections 20, 21, 22, 23, 24, and 25 of the regulation made under the PCC Act on the last page of the Course Calendar.

Applicant’s Signature: ________________________________________ Date: ___________________

Accepted By: ________________________________________________ Date: ___________________