Online Application Form for Aviation Programs

Alberta Student Number:

Social Insurance Number:

Birthdate: Day: Month: Year:
(example: 12 December 1980)

LEGAL NAMES ONLY

Family (Last) Name:

First (Given) Name:

Middle Name:

Former Name:

Title: Mr.    Mrs.    Miss    Ms.

Gender:
Male
Female

Mailing Address

Street

City

Province

Postal Code

Country

Res. Phone

Bus. Phone

E-Mail Address

Marital Status:

 Married
 Single (Never married)
 Common-Law

In Case of Emergency
Name of Person to Notify: 

Telephone: 

Citizen Status (if other than Canadian)
 Permanent Resident/Landed Immigrant    Student Visa     Other Visa

Date of entry to Canada (Non-Canadians)
Year: Month:

Country of Current Citizenship:

Country of Residence during previous year.

Mother Tongue (First Language)

Last High School Attended

Name and Address of School

From Year: Month:

To Year: Month:

Grade Level or Diploma completed:

Post Secondary Education

Name and Address of School

Last Attended: Year: Month:

Length of Program:

Certificate, Diploma, Degree Obtained, or no. of years completed:

TERM APPLIED for:  Month January February March April May June July August September October November December Day Year 2007 2008 2009

I agree, if admitted, to abide by Rules and Regulations of the College. I certify that the particulars furnished are true and complete in all respects, and that no relevant information has been withheld.

Date of Application:

Signature of Applicant: __________________________________________

As required by the Freedom of Information and Protection Privacy Act, all information regarding student applications and marks will be kept in the office of the Director of Student Services, and will be accessible only by administrative staff and instructors. Server and e-mail security passwords will protect any correspondence by e-mail.

DO YOU NOW HOLD A PRIVATE PILOT LICENCE? Yes No

PAYMENT INFORMATION:

HOW DID YOU HEAR ABOUT US?

Magazine Newspaper Website     Other:

Please include a copy of:
1) Licence
2) Medical
3) Transcripts of Academic Marks

Admission Ruling:

Please Note: Each program choice has equal precedence. Each choice will be acknowledged.