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    Application For Admission: Please Note: This Entire Form Is To Be Completed by The Applicant. Please Print Clearly

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    Januhu Zakary
    This document contains an application for admission to Qawsain Higher Education. It requests information such as the applicant's name, date of birth, citizenship, previous education history, emergency contacts, and medical insurance information. The applicant consents to Qawsain collecting and storing their personal information according to its privacy policy. They also grant permission for their photo to be used. The application checklist notes the required application materials and fees that must be submitted.

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    © All Rights Reserved
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    Application For Admission: Please Note: This Entire Form Is To Be Completed by The Applicant. Please Print Clearly

    Uploaded by

    Januhu Zakary
    57 views3 pages
    This document contains an application for admission to Qawsain Higher Education. It requests information such as the applicant's name, date of birth, citizenship, previous education history, emergency contacts, and medical insurance information. The applicant consents to Qawsain collecting and storing their personal information according to its privacy policy. They also grant permission for their photo to be used. The application checklist notes the required application materials and fees that must be submitted.

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    This document contains an application for admission to Qawsain Higher Education. It requests information such as the applicant's name, date of birth, citizenship, previous education history, emergency contacts, and medical insurance information. The applicant consents to Qawsain collecting and storing their personal information according to its privacy policy. They also grant permission for their photo to be used. The application checklist notes the required application materials and fees that must be submitted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    57 views3 pages

    Application For Admission: Please Note: This Entire Form Is To Be Completed by The Applicant. Please Print Clearly

    Uploaded by

    Januhu Zakary
    This document contains an application for admission to Qawsain Higher Education. It requests information such as the applicant's name, date of birth, citizenship, previous education history, emergency contacts, and medical insurance information. The applicant consents to Qawsain collecting and storing their personal information according to its privacy policy. They also grant permission for their photo to be used. The application checklist notes the required application materials and fees that must be submitted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    FOR OFFICE USE ONLY

    DATE RECEIVED: _________________

    RECEIVED BY:
    _________________________________

    INTERVIEW DATE/TIME:
    _________________________________

    Application for Admission NOTES:


    _________________________________
    _________________________________
    Please note: This entire form is to be completed by the applicant. Please print clearly. _________________________________

    STUDENT INFORMATION

    Legal surname/family name (must match government issued ID): Date of Birth: __________/_________/__________
    _________________________________________________________________________

    Legal given name(s): _______________________________________________________ Gender: Male Female

    Former legal name (if applicable): ____________________________________________ Citizenship: ________________________________

    Mailing address: __________________________________________________________ Status (in-person study only):

    City: __________________________________Province/State: _____________________ Canadian Citizen


    Permanent Resident
    Country: ___________________________________ Postal Code: __________________
    Temporary Resident/Visitor
    Tel: __________________________________ Cell: ______________________________ Study Permit
    Other: _________________________
    Email (this must be the student’s personal email):
    __________________________________________
    _________________________________________________________________________

    ACADEMIC RECORD (SECONDARY AND POST-SECONDARY)


    PREVIOUS SECONDARY AND PROVINCE/COUNTRY CREDENTIAL EARNED DATE OF
    POST-SECONDARY INSTITUTION(S) GRADUATION

    EMERGENCY CONTACTS (IN-PERSON STUDY ONLY)

    LOCAL (Required information) INTERNATIONAL (If applicable)

    Surname/Family Name: ______________________________________ Surname/Family Name: ______________________________________

    Given or Other Names: ______________________________________ Given or Other Names: ______________________________________

    Relationship with student: ____________________________________ Relationship with student: ____________________________________

    Tel: _______________________________________________________ Tel: _______________________________________________________

    Email: _____________________________________________________ Email: _____________________________________________________


    2

    REGISTRATION FEE AND VALIDITY

     $100.00 CDN – A registration is considered valid if paid in full.


    TUITION POLICY – COURSE WITHDRAWAL

    Students who withdraw from the course two weeks before the start date will receive a refund less a 20% administrative fee. Students who
    withdraw after the course start date will not receive a refund.

    PROTECTING YOUR PERSONAL INFORMATION

    Qawsain Higher Education collects and uses personal information to provide you with the best educational services as outlined in our Mission
    Statement. The personal information on these forms is required in order to be registered at Qawsain Higher Education and to assist Qawsain
    Higher Education in making informed decision and to respond immediately to an emergency. Qawsain Higher Education commits to using and
    storing this information responsibly and will not release this information to a third party without your written or verbal consent. If you have
    questions about Qawsain Higher Education’s use, storage or disclosure of personal information, please contact us at
    [email protected]

    YOUR CONSENT

    I consent to having Qawsain Higher Education collects personal information that may include student identification information, birth
    certificate, academic and health information, emergency contact name and number, doctor’s name and number, health insurance number and
    any similar information needed for registration.

    I further consent to the use and disclosure of information contained in this form and otherwise collected by or on behalf of Qawsain Higher
    Education (1) for the purpose of establishing, maintaining, and terminating the student’s relationship with Qawsain Higher Education, (2) for
    additional purposes identified when or before personal information is collected, and (3) as otherwise provided in Qawsain Higher Education’s
    Personal Information Privacy Policy, a copy of which is available on request. I also consent to the collection, use and disclosure of such personal
    information by and to agents, contractors and service providers of Qawsain Higher Education.

    PERMISSION

    I hereby give permission to Qawsain Higher Education to have pictures taken of me for general record keeping purposes and for Qawsain
    Higher Education’s website, brochures, Facebook and Instagram.

    APPLICANT SIGNATURE: ______________________________________________________ Date signed: _______________________________

    DECLARATION OF APPLICANT

    In signing this document, I certify the following:.

    • All statements on this application and supporting documents are true and complete.

    • I authorize Qawsain Higher Education to verify any information provided as part of this application.

    • I understand the evidence of falsified documents or misrepresentation will result in the cancellation of my admission or registration.

    • I understand the information about falsified documents is shared with other Canadian colleges and universities.

    • I understand and acknowledge that it is my responsibility of be aware of, and comply with all Qawsain Higher Education policies and
    procedures.

    • For Non-BC Residents, I agree to purchase medical insurance if needed to cover my period of study in Vancouver.

    • Admission is subject to assessment of qualifications and availability of seats.

    APPLICANT SIGNATURE: ________________________________________________________ Date signed: _____________________________

    July 2018
    3

    APPLICATION CHECK LIST

     Application Fee
     Completed application form
     Full course payment via Paypal
     Scanned copy of medical insurance coverage during length of study in Vancouver (Non-Residents only)
     Scanned copy of Government issued ID

    To expedite the application process, students may submit electronic (scanned) copies of application forms and official documents for
    consideration to [email protected]. All scanned official documents must be in PDF format, in colour, show the entire page,
    and include both sides (front and back, even if blank) of all pages. Original documents may be requested at any time. Students who fail to
    provide official documents as requested may have their application canceled, and/or blocked from further registration.

    MEDICAL INFORMATION (IN-PERSON STUDY ONLY)

    For applicants studying in Vancouver ONLY. Not for online applicants.

    Insurance provider:
     MSP - Personal Health Card Number: __ __ __ __ __ __ __ __ __ __
     Private – Name of company: ____________________________________________________

    Please provide a copy of your Plan or a proof of insurance for the length of your study.

    Use this space if there is anything else you want us to know about yourself that will enable us to plan for and better assist you should a medical
    emergency occur:
    ______________________________________________________________________________________________________________________

    ______________________________________________________________________________________________________________________

    ______________________________________________________________________________________________________________________

    APPLICANT SIGNATURE: ________________________________________________________ Date signed: ____________________________

    July 2018

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