Student Registration Form

STUDENT REGISTRATION

Course (choose one)

Course Date

Business/Community Name

First Name

Middle Name

Last Name

Address

City

Province

Postal Code

Mobile Phone Number

Email Address

Date of Birth

Gender

Citizenship

Proof of Citizenship (Birth Certificate, Passport, Status Card)

Current Government ID (Driver's licence, Provincial ID Card, Health Card, Firearm Licence, etc)

Photo (please attach a passport quality photo of yourself that has been taken within the last 3 months)

Have you ever been charged and/or convicted of a criminal offence?

Yes No

If yes, attach a Statement and/or Certified Criminal Record Check

Confirmation of Fingerprints

Would you like assistance with your security licence application?

Yes No

If yes, please attach Security Licence Application here.

Your response to these questions is voluntary. All responses are confidential and are protected under the Privacy Act.

I understand

If you require help to submit security application – please download the application form here: Security Licence Application (BC) complete the form, scan and attach above.

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Student Registration Form

STUDENT REGISTRATION

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