Vuc_application For Admission

                        

Admission Form e-Learning Technology Virtual University

                                                        Mill Cove Plaza, Bedford Highway Mid 48068 Bedford, NS - Canada B4A 3Z2 TEL: 1-902-832-1188 - FAX: 1-877-832-5131

ADMITTED Academic Year Beginning on: ______ /

Yes /

No Three Recent Colour Photographs

/

________________________________________________________________________ For EVU Use Only:_______________________________________________________________

Please make sure to fill the form completely, using block letters and writing clearly First Name _________________________________

Family Name_________________________________ Full Name___________________________________________________________________________________ Home Permanent Address____________________ Mailing Address ______________________________ (if different) ___________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

Telephone #. ____________________________

Mobile #. ____________________________________

Fax: No. :_______________________________ e-mail address:________________________________ Date of Birth (Mo/Day/Yr)_________________ Married Single Male Female Nationality_______________________________ Native Language______________________________ Current occupation/Position_________________________________________________________________

Proposed study at ETVU_________________________________________________________________ Financial Arrangements: What kind of method you choose to pay your Fees? _____________________________________________________________________________________ _______________________________________________________________________________________

Page (2)

Academic Qualifications All applicants must enclose a transcript of their academic record, giving their marks or grades in each year of their course, program of study. No.

Qualifications

Subjects

College/University + (City, Country)

From

To

Awarded Date

Please note: All applicants must provide proof of their qualifications. Other Qualifications: ____________________________________________________________________________________________________

Professional Experience: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

Referees: Mention names, titles, and full address of two referees who can inform the college of your academic ability, your Character and your capacity for advanced study. 1.________________________________________ _________________________________________ _________________________________________ _________________________________________

2.________________________________________ ________________________________________ ________________________________________ ________________________________________

Additional Information if any: __________________________________________________________________________________________________ __________________________________________________________________________________________________

How did you come to know ETVU? ____________________________________________________________________ This document is a form of application only. The University reserves the right to refuse admission to any candidate. False or misleading information given on this form or academic credentials will result in rejection of the application without refund fees. When completed, this application and supporting documents should be sent to the Registrar office (by registered Air Mail)

Applicant Signature: _________________________________________________________Date:___ /___/______

www.e-education.ca/eTVU