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To apply to one of Native Education College's many programs, fill out Personal, Education Info and NEC Program areas. The * red star indicates that this information must be filled out to complete the form. Thank you.

Personal

First Name: *

Middle Name:

Last Name: *

Preferred First Name:

Street Address: *

Town/City: *

Province: *

Postal Code:

Secondary Number:

Contact Phone Number: *

Email:

Date of Birth: *

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Gender:

Male

Female

Native Ancestry:

How did you hear about NEC?: - None -NEC gradFamily MemberFriendNewspaperSkytrain PosterAPTNCareer FairBrochureNewsletterOther

Emergency Contact Name:

Emergency Phone Number:

Education Information

1) School Attended: *

City/Province:

Date Attended:

Grade Completed / Year Completed: *

2) School Attended:

City/Province:

Date Attended:

Grade Completed / Year Completed:

3) School Attended:

City/Province:

Date Attended:

Grade Completed / Year Completed:

NEC Program(s) Applying for

First Choice: *

Aboriginal Adult Basic Education

Health Care Assistant Certificate Program

Applied Business Technology

Aboriginal Justice Studies

Aboriginal Tourism

Family & Community Counselling

College Connections

Aboriginal Early Childhood Education

Aboriginal Land Stewardship

Northwest Coast Jewellery Arts

Second Choice: *

Aboriginal Adult Basic Education

Health Care Assistant Certificate Program

Applied Business Technology

Aboriginal Justice Studies

Aboriginal Tourism

Family & Community Counselling

College Connections

Aboriginal Early Childhood Education

Aboriginal Land Stewardship

Northwest Coast Jewellery Arts

Other:

Starting Year:

Starting Semester:

Spring

Summer

Fall

Word verification: * (verify using audio)

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