Continuing education registration

Please don't fill out this input box.

Personal Information

Have you ever attended North Island College?*

Yes

If yes, NIC student #

Legal last name*

First name*

Middle name

Former last name, if applicable

Preferred first name

Mailing address*

City*

Province*

Country*

Postal code*

Home phone*

Other phone

Email address*

Birth date*

Gender*

Female

Male

Non-binary

Other

I prefer not to say

Emergency contact name*

Home phone*

Other phone

Citizenship Status*

Canadian citizen

Permanent resident

International student

Country of origin if permanent resident or international student

Course Selections

Course code*

Course name*

Start date*

Course code

Course name

Start date

Course code

Course name

Start date

For Sponsored Students Only

Sponsoring organization/company

PO #

I hereby authorize the release of all academic records relating to my admission or education to the sponsoring agency.

Student signature

Date

Voluntary Disclosure

Do you identify yourself as an Indigenous person?

Yes

If so, are you

First Nations

Metis

Inuit

Do you have a disability/medical condition?

Yes

NIC will provide you with information about receiving support services.

Declaration

Please read the following before signing:

I declare that the information I have submitted on the application is true and correct. Falsifying any document or information submitted will result in the immediate cancellation of admission or registration at the College. I understand that this information along with subsequent information is collected under the authority of the College and Institute Act and section 26 of the Freedom of Information and Protection of Privacy Act (FOIPPA). Information collected will be used for the purposes of: admissions, registration, grade notification, income tax receipts, research, awards, alumni contact, special events and other activities consistent with the mandate of the institution. NIC collects, uses, retains and discloses information within the College to carry out its mandate and operations in accordance to Policy 1-01 Freedom of Information and Protection of Privacy. Should you have any questions about the collection of information please contact the FIPPA Analyst located at 2300 Ryan Road, Courtenay, BC, V9N 8N6, or email foipp@nic.bc.ca.

Student Signature*

Date*

Payment options

ONLINE: Visit www.nic.bc.ca/continuing-education and click Register for Continuing Education Courses
MAIL: Mail completed registration form to Student Services with payment by cheque with full fees. No post-dated cheques are accepted. To help prevent credit card fraud DO NOT include your credit card information.
EMAIL: Submitting this form will go to NIC Comox Valley Continuing Education: CETinfo-cv@nic.bc.ca. A staff member from the Continuing Education department will contact you to take payment when the registration is processed.

Please select payment option*

By phone

In person

Continuing education registration

Questions? Please call 1-800-715-0914