Voluntary Disclosure

*You may voluntarily provide the personal information listed below:

Do you identify yourself as an Aboriginal person, that is, First Nations, Métis, or Inuit?

Yes

If you answered “Yes”, please indicate:

Aboriginal Group

First Nations

Metis

Inuit

Not Applicable

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

Yes

Describe your special condition / disability here, if applicable. (Optional)

PROGRAM & INTAKE PREFERENCE

Select Program

Select Intake

EMERGENCY CONTACT

Name

Relation

Phone Number

PLEASE SUBMIT THE FOLLOWING DOCUMENTS

Passport Copy

Secondary/Post-Secondary Education Transcripts

English Language Test Result Copy

Input the Agent Code only if you are an agent or if an agent asked you to submit using their Agent Code.

By clicking on the Submit button, you are giving your consent for Career City College to view and evaluate your information and uploaded documents as part of the admission process. You are also giving your consent to be contacted by Career City College via text, email and/or phone multiple times during and after your admission process.

Acknowledgment Statement

By submitting this form, I understand that I must meet all entrance requirements and prerequisites to be accepted as a student at Career City College. I understand that my application is subject to review, and that I will not be enrolled until I receive and sign the Student Enrollment Contract and other necessary documentation.

I agree that by submitting this application, I am electronically signing the application. I hereby confirm my understanding and acceptance of the information provided in this application. To the best of my knowledge the information I have provided is accurate. I understand that once I submit my application and begin the registration process, I will receive a copy of the refund policies.

I understand that my information will be held in accordance with Career City College's Privacy Policy - we do not use or disclose personal information for purposes other than those for which it was collected, except with the consent of the individual or as required or permitted by law.

PRIVATE TRAINING INSTITUTIONS BRANCH

Tel: (604) 569-0033 or 1-800-661-7441 - www.privatetraininginstitutions.gov.bc.ca

Please be advised that under section 61 of the Private Training Act, the Registrar is authorized to collect, use and disclose personal information in accordance with the Registrar's regulatory duties under that Act. Accordingly, this institution is authorized to disclose your personal information to the Registrar for regulatory purposes.