RSCC HEART Program Application SQ

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone Number (including area code)

Cell-phone Number (including area code)

Email

example@example.com

Skype

Skype address

Date of Birth (dd/mm/yyyy)

Place of Birth (city, country)

Would you like to receive email news and updates from RSCC?

YesNo

SIN Social Insurance Number (for Canadians who want an Education Tax Receipt) The Canada Revenue Agency requires this information to be included on the receipt. If you don't want to put this info in the form you can provide it to us by phone or email.

Citizenship

Canadian Immigration Status

Name of Emergency Contact

First NameLast Name

Phone Number of Emergency Contact (include area code)

Email Address of Emergency Contact

example@example.com

Relationship to You of Emergency Contact

How did you hear about this program?

Education: Foundation Studies (email scan or photo of transcript, if not from RSCC)

List Dates, Institutions, Places, and Degrees

Education: Waldorf Teacher Education (email diplomas and certificates)

List Dates, Institutions, Places and Degrees

Education: Univ., College, etc. (please email scans or photos of transcripts)

List Dates, Institutions, Places, and Degrees for each university, college, or training centre.

Waldorf Teaching Experience

List Dates, Schools, and Responsibilities. Also indicate whether positions were paid or volunteer.

Other Teaching Experience

List Dates, Schools, and Responsibilities. Also indicate whether positions were paid or volunteer.

Other Work Experience

List Dates, Organizations, and Responsibilities. Also indicate whether positions were paid or volunteer.

What are your reasons for wishing to enter the program at this time?

List personal skills, artistic and musical abilities relevant to Waldorf teaching

In addition to emailing (to info@rscc.ca) copies of your Foundation Studies and University or College degrees, diplomas and or Certificates, we will also need you to include two letters of reference (one professional and one personal).

You will also need to pay a non-refundable application fee of $100 (CDN) online. You have the option of paying with a Visa or Mastercard credit card.

Additional Comments

Application Processing Fee (non-refundable)*

RSCC Teacher Education Application Fee $100.00CAD

Total $0.00CAD

Credit Card

RSCC HEART Program Application SQ:

Credit Card