New APPLICATION FOR ADMISSION FORM

Red Crow Community College

PO Box 88, Stand Off, AB T0L 1Y0

APPLICATION FOR ADMISSION FORM

PROGRAM OF CHOICE

Program

For Adult Upgrading only: Note this program is offered both at the College's main campus (Stand Off) and satellite campus (Lethbridge.) Please select the campus of your choice.

Campus

Preferred Start Date

Student Status

(Adult Upgrading only)

Have you previously applied to Red Crow Community College?

Yes No Not Selected

RCCC Student number (if known)

Educational / Occupational Goals

Please indicate what your educational/occupational goals are

PERSONAL INFORMATION

First Name

Middle Name

Last Name

List of Former/Maiden Names (if applicable)

SIN No:

Aboriginal Ancestry Declaration (optional)

If Aboriginal ancestry, please indicate (optional)

Tribe/Band Name (if applicable)

Treaty No.

First language

Birth Date

Gender

Home Phone

Cell Phone

Street / PO Box

City

Province or State

Postal code/Zip

Country

Childcare requirements. Note: Daycare services are only available at Main Campus (Stand Off)

Do you require daycare?

Yes No Not Selected

Number of children requiring daycare

Age of children requiring daycare

Emergency Contact Information

Contact Name

Relationship

Cell Phone

ACADEMIC INFORMATION

Official transcripts are required before your application can be processed.

Request official high school transcripts from Alberta Education.

Request official post-secondary transcripts from your institution's Registrar's Office. The registrar will issue your transcripts directly to Red Crow Community College.

Alberta Student Number (ASN)

(If applicable)

Last High School Attended

High School City/Province

Last year attended

Academic status at the time of application

Detailed Academic Reports (DAR)

Record of high school course marks and credits issued directly to a student

Previous Post-Secondary Institutions if applicable (Most recent First)

1. Name of College, Technical Institute or University Attended

1. Program of Study

1. Institute City/Province

1. Month/Year attended to

Academic status at the time of application

2. Name of College, Technical Institute or University Attended

2. Program of Study

2. Institute City/Province

2. Last year attended

Academic status at the time of application

FUNDING INFORMATION

My tuition, books, and fees will be paid by:

If other, please specify

Approval progress is:

Name of funding contact person

Contact person's phone

Additional application documents

Program-specific requirements, such as essays or resumes, listed under program descriptions at http://www.redcrowcollege.com

Essay

(requirement for Niitsitapi Teacher Education Program and 2+2)

Resume

(requirement for Niitsitapi Educational Assistant Program)

STUDENT SIGNATURE

Applicant's signature

Please type in your name as your electronic signature.

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT
I agree, if admitted to Red Crow Community College, to comply with College regulations. I certify that the information in this application is true and complete in all respects and I have withheld no information. I also understand that any misrepresentation on my part may result in cancellation of my admission or registered status. Falsification of documents or withholding of requested information regarding this application are serious offences. I agree that RCCC retains the right to nullify my application if the information is false or incomplete. The personal information requested on this form is collected under the authority of section 33(c) of Albert’s Freedom of Information and Protection of Privacy Act for the purpose of determining eligibility for College admission and/or the administration of academic programs and student services. Certain personal information may be made available to federal, provincial and First Nation government departments and agencies under appropriate legislative authority. For information about the collection and use of this information contact Red Crow Community College 403-737-2400.