Rev.
July 24
, 2018
APPLICATION FOR CREDENTIAL
Office of the Registrar
2300 Ryan Road
Courtenay, BC V9N 8N6
T: 1-800-715-0914 E: forms@nic.bc.ca
Print name (below) exactly as you want it to appear on your document
Address where credential will be mailed
Month/Year you expect to complete or have completed your program.
__________________________
_____________________
YEAR
Have you been given approval for any substitutions or exemptions: ☐ Yes ☐ No
Please indicate if you are in Co-op Education: ☐ Yes ☐ No
Note: One Complimentary Non-Official Transcript will be included with your credential at no charge.
DEGREES
☐ Bachelor of Business Administration
ASSOCIATE DEGREES
☐ Associate of Arts
☐ Associate of Science
DIPLOMAS
☐ Aquaculture Technician
☐ BC Adult Graduation
☐ Business Administration Diploma
Option _____________________
☐ Bus Admin – Post Degree Diploma
Option
_____________________
☐ Criminology
☐ Culinary Business Operations
☐ Early Childhood Care & Education
Option ___________________
☐ Fine
Arts
☐ Human
Services
☐ IMG
–
Adv.
Communication Design
☐ IMG
–
Communication Design
☐ IMG
–
Web & Mobile Application
Dev.
☐ Industrial Automation Technician
CREDENTIAL COMPLETED (check one)
☐ Practical Nursing
☐ Social Service
☐ Tourism & Hospitality Management
Option _____________________
☐ Global Tourism & Hospitality Management
– Advanced
CERTIFICATES
☐ Aboriginal Leadership
☐ Activity Assistant
☐ Adventure Guiding
☐ Aircraft Structures Technician
☐ Applied Business Technology
Option _____________________
☐ Aquaculture Technician
☐
Automotive Service Technician
Foundation Harmonized
☐ Business Administration
☐ Carpentry Foundation Harmonized
☐ Coastal Forest Resource
☐ Early Childhood Care & Education
☐ Electrician Foundation Harmonized
☐ Electronics Technician Core
☐ Engineering Foundations
☐ Health Care Assistant
☐ Heavy Mechanical Foundation
☐ Hospital Unit Clerk
☐ HS – Ed. Asst. /Community Support
☐ HS – Ed. Asst. /CS, Indigenous
☐ IMG – Web Design
☐ Joinery/Cabinetmaking Foundation
☐ Metal Fabrication Foundation
☐ Metal Jewellery Design
☐ Mobile Application Development
☐ Plumbing & Piping Foundation
☐ Professional Cook Level ___________
☐ Professional Photography
☐ Tourism & Hospitality Management
☐ Global Tourism & Hospitality Management
– Advanced
☐ Underground Mining Essentials
☐ Welder Foundation Harmonized
If program is not listed, please indicate
here:
_________________________________
The information on this form is collected under the authority of the College and Institute
Act, and will be used for the purpose
s
ho
w
n
ab
ove
.
Queries about the
c
oll
ecti
on
o
r
cor
r
ecti
on
of
p
e
r
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onal information should be addressed to the Registrar at the address on the top of this form.
I give North Island College permission to use my name and achievements in graduation publications or announcements.
I hereby authorize North Island College to release my student records to the addressee on this form.
______________________________________________
____________________________________
Student Signature
Date (mmm-dd-yyyy)
FOR SRO USE ONLY
Date Received:
______________________
____________________________
Received By: __________________________________________________
