Personal Information

Name as it appears on your drivers license.

 

First Name:*
Last Name:*
Gender:*



Marital Status
Birth Date:*
Address:*
Address2:
City:*
Province/State:*
Country:*
Postal/ZipCode:*
Phone (Primary):*
Cell Phone (Optional):
E-Mail:*
Status in Canada*

Voluntary Disclosure

Do you identify yourself as an Indingenous person, that is, First Nations, Metis or Inuit?

Yes
No

If you answered “Yes”, please indicate if you are:

First Nations
Metis
Inuit

Do you have a long-term physical or mental health condition that limits the kind of activity that you can perform on a daily basis?

Yes
No

Program & Campus

What campus would you like to attend:*
Program:*
When are you available to start school?*

Emergency Contact

Emergency Contact Person Name*
Emergency Contact Person Phone Number*
Emergency Contact Personal Email
Contact Person Relationship*

Education and Employment Background

High School:
High School Grad Date
Highest Grade/Level Completed (Credential Awarded)
Employer
Work Type
Hrs/Wk
Do you currently own a laptop?*

You have to type in your name to submit your application. This is your electronic signature. Your given name and last name must be exactly the same as on your application form.

I understand that I must meet all entrance requirements and prerequisites to be accepted as a student at Sprott Shaw College.

I agree that by submitting this application, I am electronically signing the application. I,

 

Full Name*

, hereby confirm my understanding and acceptance of the information provided above and attest to the accuracy of the information I have provided. Further, I acknowledge that I have read and understand the refund policies.

By submitting this form, I agree that Sprott Shaw College may call, text and/or email me about their educational services at the contact information provided, including a wireless number, using automated technology. Please note, this consent is not required to attend their institutions and you may unsubscribe at any time.