The Goderich Signal-Star, 1983-08-17, Page 93Application/R -sgistrMti n F rm
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:
e Course -
Specify your choice of time slot it
More than one class is advertised on
the same day
Name:
NOTE: THIS IS NOT A RECEIPT.
Day Starts
17,
Address:
First Name
Last Name:
Apt. No. No. and Street
Postal Residence
Code Telephone:
City:
Business
Telephone:
Employer
Please check one of the following:
(a) I am under 19 and have successfully completed Grade 12 D or,
(b) I am under 19 and have not successfully completed Grade 12 n or,
(c) I am a Senior Citizen (Age 60 and over) ❑ or,
(d) I am over 19, but not a senior citizen ❑
Sex. Male L:3
Female Li
Cheque or Money
Order enclosed for $ (full course fee) payable to Conestoga College.
We do not accept post-dated cheques.
Registration is lirnited toCitizens and/or immigrants special permission been Employment Immigration
Canada. You
may apply
for
a prorated refund before the end of the third scheduled class. For additional formation please refer to the Refund section
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
It there is a mad interruption please take your Appkcat,on/Registration Form to the campus Offering the course
FOR MORE CAMPUS INFORMATION:
Harrlston and Mount Forest Area - Page 52
Listowel and Milverton Area - Page 53
Wingham Area - Page 39
Cambridge Campus - Page 35
Guelph Campus - Page 46
Clinton Campus - Page 38
Stratford Campus - Page 55
Doon Campus - Page 40
Waterloo Campus - Page 58
REGISTER EARLY! DON'T BE DISAPPOINTED! CLASS SIZES ARE LIMITED!