ABE / ESWP 2024-2025 Application for Admission

Program Location

Name

Surname (Last name)

First Name

Middle Name

Maiden or Previous Surname(s)

Gender Male Female Not Specified

Date of Birth

Social Insurance #

Address

Street, PO Box #

City

Province

Postal Code

Home Phone Number

Cell Phone Number

E-mail

Emergency Contact Information

Name

Relationship to You

Cell/Phone #

Are you a First Nation member? Yes No

If yes, to which First Nation do you belong?

Are you Metis? Yes No

If yes, are you a Registered Metis Citizen Non-registered Metis

Are you Inuit? Yes No

Is English your first language? Yes No

If No, proof of English proficiency is required.

K-12 Schooling

Name & location of the last K-12 school you attended

Last year you attended K-12 school

What grade have you successfully completed?

Adult Basic Education (ABE)/Essential Skills (ESWP)

Have you previously attended (ABE)/(ESWP) Yes No

If yes, location of former ABE/ESWP program

If yes, last year attended

What is your education and/or career goal?

A new anti-spam law came into effect July 1, 2014 in Canada, we now need your consent to contact you:

I hereby consent to Southeast College sending me program related information, notifications, invitations etc., via e-mail, text, or other electronic means. I understand that I can change my preferences and unsubscribe from receiving such materials at any time. I consent to the above

Southeast College reserves the right to amend or cancel programs or courses at its sole discretion at any time. I agree

The information on this form is collected under the legal authority of the Regional Colleges Act 1988 and the Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP). The information is used for administrative and statistical purposes by Southeast College and/or Ministries and Agencies of the Saskatchewan Government and the Government of Canada. If you have any questions about the collection or use of this information please contact the Registrar, Southeast College.

I hereby certify that all the information on this form is true and complete. I understand that false information may result in the cancellation of my status as a registered student. If admitted I agree to abide by the rules and regulations of the institute, including the payment of fees.

Date

Signature

Required Field