Printable Registration Form
Please make copies if applying to more than one course – USE ONE FORM FOR EACH COURSE!
PERSONAL INFORMATION |
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| First Name: _______________________ Last Name: _______________________ Address: _________________________ City: ____________________________ Province / State:___________________ Postal Code: ______________________ Home Phone: (___)_________________ Home Fax :(___)___________________ |
School Board:______________________ Address:___________________________ City: _____________________________ Province:____________________ Postal Code:_______________________ Title/Position:______________________ Business Phone: (___)________________ Business Fax: (___)__________________ Email:_____________________________ |
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COURSE(s) |
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| (please use one page per course registration) | ||||||||||||||||||||||||||||||||
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BACKGROUND INFORMATION
Current Education Level:
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High School | |
College Diploma | |
University Degree | |
Master's Degree |
Please select the category which best describes you:
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Manager | |
Specialist |
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Supervisor | |
Superintendent |
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Director | |
Other_____________________ |
How many years working within the School Board environment? ___________
How did you learn about the Diploma in School Board Administration?
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PAYMENT INFORMATION:
Tuition
costs: $ __________ |
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Cheque/Money Order *(Payable to the University of Guelph) |
Card #_____________________________ |
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Visa | Cardholder: ____________________________ |
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Master Card | Expiry: _____ /_____ |
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American Express | Signature: _____________________________ |
OOL Bursary: |
Protecting Your Privacy: |