Course Registration Form

Student Registration Form

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province/ Country

Postal / Zip Code
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Where are you from?
How long have you been in Canada?
CitizenPermanent ResidentOpen Work PermitStudentVisitorOutside of CanadaRefugeeOther
I work Part-TimeI work Full-TimeI am not workingI study Part-TimeI study Full-TimeI don’t go to School
Program of Interest
I want to start classes:
YesNo
IELTS Information, I need IELTS for: Immigration/Citizenship School Professional Designation Other. Please specifyblank
YesNo
IELTSTOEFLCAELCELPIPNoneOther
If Yes, my score was
I Need to have a score of
YesNo
IELTS GeneralIELTS Academic
I am a current student at Anderson College Yes No blanks is my Program. My student ID isblank
YesNo
What program are you interested in?
Why did you choose Anderson College?
Monday at 5:30 PMWednesday at 1:15 PMThursday at 5:30 PMFriday at 12:30 PM
Upload a copy of your one piece of ID*

You can upload a copy of your Driver's Licence, passport or PR card
Cancelof
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Student Registration Form