Kingston Learning Centre Student Registration Form
742 Arlington Park Place, Kingston, ON   K7M 8H9
Phone: 613-384-6194 * Fax: 613-384-9459 * Toll: 1-888-732-0326 * Email:klc@cogeco.net   
Private Career College registered under the Private Career Colleges Act, 2005

PERSONAL INFORMATION

STEP 2 - COMPLETE THE REGISTRATION FORM
ALL FIELDS MUST BE COMPLETED!

Student Name :


Surname   First Name(s)
Address:
  Street    
 
  City Province Postal Code

Home Phone:  
Email:
  

 

DATE OF BIRTH:
(Bartending Only)

 

   
 
YYYY-MM-DD
   

 

Emergency Contact Name:

 

Phone:

 

** KLC reserves the right to contact medical authorities without prior consent in the case of an emergency

Part Time/General Interest Courses:

Full tuition must be paid before the start of any course. Withdrawal from a course will be accepted up to 24 hours prior to the start of any course. A full refund, minus $25.00 administration fee, will be issued if proper notification is received. NO REFUND WILL BE PROVIDED AFTER THE FIRST SESSION OF TRAINING. A full refund will be issued if KLC cancels a course due to insufficient enrolment. KLC reserves the right to make changes to course scheduling.

Course: Website Development - ColdFusion / MS Access
 Instructor:
Campus Location: Kingston
    
Requested Start Date:

We will confirm your requested start date


YYYY-MM-DD

    
Notes:

These courses are not offered under the Private Career College Act, R.S.O. 2005

Application Date: 2010/Sep/09

Revised 2007-07-31