Adult Basic Education & Skills Training Application

This application form is for all foundational learning and other adult basic education and skills training programs.
 
 
Tips for filling out this form
  1. Please use a desktop or laptop computer to fill in this form. It's much easier than trying to use a mobile phone.
  2. You may have difficulties submitting the form if you use Internet Explorer as your browser. Chrome, Edge or Firefox are better options.
  3. Some of the questions are required. If you see this symbol *, then the question must be answered. If you don't answer it, then your form won't submit.
  4. If you hit submit and aren't immediately directed to a thank you page, then you've missed answering a question. Scroll up the page and look for a message in red and answer the question(s).

Full Name
First Name:*
If you don't have a middle name, please put in n/a
Middle Name:*
Last Name:*

More About You
Birthdate (yyyy/mmm/dd eg 1980/Jan/01*
Age:*
Gender
Health Care Number:*
What province is your health care coverage from?*
Are you a Canadian citizen?:*
If you wish to declare you are an Indigenous person, please select one of the following:
Do you need services offered to students with disabilities or medical needs?
If you need those services, please describe or list:

Address & Contact Information
House/Street Address:*
Town/City/Municipality:*
Province:*
Postal Code:*
If different, your mailing address:
Best phone number to call:*
Other phone number:
Email address:*

Program
Choose a program:*
How did you hear about the program?*
I plan to begin studies (month/year):*

Education History
What was the last grade you completed?*
What year was this?*
What is the name of the last high school you attended:*
In what province was the school located:*
Where is this school located (town/city/municipality):*
If available, we will require a transcript of your high school marks. You may request them through your province's education department.
If you have attended any post-secondary college/university, please fill in its name:
Where is this post-secondary school located -- town/city and province:
What years did you attend this post-secondary (from when to when):
If you did attend post-secondary, what did you take and when?:
If you earned a credential, please indicate:

Have you taken any other skills training? Please list what it was, where you took it and when:

Job History
Please list the job(s) youve had in the past 2 or 3 years:*
Choose one of the jobs--the longest one or most recent--and answer the following questions.
What did you do at this job?*
How did you get the job? For example: answered an ad, a friend/relative referred you, dropped resume off at a business*
What is an example of something you really liked about the job:*
What is something you didn't liked about the job:*

Transportation

Attending individual classes and programs may require activities that take place off-campus. You are responsible for ensuring that you have your own or alternative reliable transportation to and from the college as well as other designated off-campus locations.
  I confirm that I have reliable transportation to and from the Lakeland College campuses as well as other designated off-campus locations.

Your Goals
What do you see yourself doing in the next year? How does training fit into your plans?*
What do you see yourself doing/working at in 4 years?*
How do you think this program will help you?*
How do plan to succeed in this program?*
Is there something that might stop you from attending classes or completing the program?*
If you answered yes, please explain what might prevent you from completing the program. (surgery, family illness, court case, child care):*

Third Party Disclosure (optional)

Please fill this out if you want a parent/spouse to provide information or access information about you.

This authorization will remain in effect as long as you are an active student at Lakeland College. You may request changes in writing to the registrar's office.
Full name of the authorized person:
What is this persons relationship to you?
Street/Box/RR Address:
Town/City:
Province:
Postal Code:
Best phone number for your authorized person:
Alternate phone number:
Email address:
Please allow the above named person to give/receive information about me.Please check all that apply.
 My personal data (name, address, email)
 My admission status
 My financial status and student receivable account (what the college is owed)

Applicant Declaration

I certify that all the information supplied in this application is true and complete in all respects. I understand misrepresentation, falsification of documents or withholding requested information are serious offences and will result in the cancellation of my admission and registration at Lakeland College. If admitted, I agree to abide by the existing or amended rules and regulations set by the Lakeland College Board of Governors.
Date completed (mon/dd/yyyy):*
 I do*
If you wish to receive emails from Lakeland College, you must opt-in by clicking the box. You may unsubscribe at any time.*
 
Note: If you hit submit and aren't redirected to a thank you page, then you have missed one of the required questions. Please scroll up and you'll see a message in red. Answer the question(s) and then click on submit again.
 
Lakeland College complies with the Freedom of Information and Protection of Privacy Act (FOIP Act) of Alberta. Personal information collected on this form is collected under the authority of the Post-secondary Learning Act and Section 33(c) of the FOIP Act for the administration of the Foundational Learning Program. This information is used in the normal course of College operations in accordance with this legislation. If you have any questions about the collection and use of this information, please contact the FOIP coordinator at FOIP@lakelandcollege.ca. If you have any questions about the Foundational Learning Program or the completion of this form, please contact foundational.learning@lakelandcollege.ca.