HomeMy WebLinkAboutThe Wingham Advance-Times, 1985-12-04, Page 146Application/Registration Form
Please print all information
Return form to the Campus offering the course. We would
appreciate a separate cheque for each course.
CONTINUING EDUCATION - APPLICATION/REGISTRATION FORM
Campus: Course Number:
Course:
Day'
Specify your choice of time slot it
more than one class is advertised on
the same day
Name
Address
City
NOTE: THIS IS NOT A RECEIPT.
Starts
Last Name
First Name
Sex Male L7
Female L]
Apt No
No and Street
Postal Residence
Code: Telephone.
Employer Business
Telephone
Are you currently registered through the Registrar's Office in a full-time day Program at Conestoga College?
Yes No
If YES to above, please enter your Student I.D.
Please check one of the following:
(a) I am under 19 and have successfully completed Grade 12 ❑ or,
• (b) I am under 19 and have not successfully completed Grade 12 Li or,
(c) I am a Senior Citizen (Age 60 and over) C or,
(d) I am over 19, but not a senior citizen C
How Did You Find Out About Conestoga College.Continuing Education Courses:
Radio Friend
Newspaper
Catalogue
Other
(Please specify)
Cheque or Money
Order enclosed for $ (full course fee) payable to Conestoga College.
We do not accept post-dated cheques.
Registration is limited to Canadian Citizens and/or Permanent Residents unless special permission has been granted by Employment and Immigration
Canada. You may apply for a refund before the start of the third scheduled class. For additional information please refer to the Refund section in the front
of the catalogue. We do not accept registrations or reserve spaces over the telephone. It is the responsibility of each student to be enrolled in a Health
Insurance Plan or OHIP.
Applicant's Signature:.
Date:
Note: Applications must be signed and dated.
( CAMPUSES
Cambridge Campus
1305 Bishop Street N.
Cambridge, Ontario.
N1R 6Z2
(519) 623-4898
Doon Campus
299 Doon Valley Dr.
Kitchener, Ontario.
N2G 4M4
(519) 653-7460
Clinton Campus
Vanastra Rd.
P.O. Box 160
Clinton, 'Ontario.
NOM 1L0
(519) 482-3458
Stratford. Campus
270 Water Street
P.O. Box 848
Stratford, Ontario.
N5A 6W3
(519) 271-5700
Form R084
Guelph Campus
460 Speedvale Ave. W.
Guelph, Ontario.
N1H 6N6
(519) 824-9390
Waterloo Campus
435 King Street N.
Waterloo,' Ontario.
N2J 2Z5
(519) 885-0300
11 there is,a mail interruption please lake your Application/Registration Form to the campus offering the course
REGISTER EARLY! DON'T BE DISAPPOINTED! CLASS SIZES ARE LIMITED!