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APPRENTICE PERSONAL INFORMATION Have you applied to or

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Country of origin: CANADA
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Have you applied to or attended Camosun College before?
No Yes. Please provide your Camosun College Student Number:
Interurban Campus
4461 Interurban Rd.
Victoria BC V9E 2C1
1-
250-370-3550 Option 3
877-554-7555 (Toll-free)
apprentice@camosun.ca
PERSONAL INFORMATION
CURRENT MAILING ADDRESS
EMERGENCY CONTACT
VOLUNTARY DISCLOSURE
APPLICATION FEE
APPRENTICE
ITA# (required for apprentice course registration)
LEGAL LAST NAME FORMER LAST NAME (if applicable)
LEGAL FIRST NAME PREFFERED NAME (if applicable) MIDDLE NAME(S) Check if you have none
CITIZENSHIP STATUS Canadian
If you are not a citizen of Canada, please select your ocial status in Canada (documentation required):
Permanent Resident/Landed Immigrant, document number:
Other Visa or Permit, specify and provide document number :
Refugee / Convention Refugee, document number:
Live In Care Giver, document number:
International students please contact Camosun International to obtain an application package. Telephone: 250-370-3682 or 250-370-4812.
DATE OF BIRTH GENDER SOCIAL INSURANCE NUMBER (optional*)
By completing this section, you indicate you understand that you may be contacted by the school, based on the information you provide.
Are you of Indigenous ancestry? (First Nations, Mėtis or Inuit) Yes No
If Yes, are you First Nations Status First Nations Non-Status Inuit Metis
Do you require additional support services due to a disability? Yes No
Note: If you require additional academic supports, in the classroom or during exams, due to learning/psychological/physical related barriers, please
contact the Centre for Accessible Learning to discuss in more detail. www.camosun.ca/services/accessible-learning/
Payment of $44.38 is due with this application.
Visa Mastercard American Express JCB
Male Female
*Providing your SIN helps us to ensure
the accuracy and completeness of your
transcript and your tuition tax receipt.
NUMBER/STREET CITY PROVINCE POSTAL CODE
HOME TELEPHONE NUMBER CELL PHONE NUMBER BUSINESS TELEPHONE NUMBER
EMAIL ADDRESS (required)
CONTACT NAME CONTACT PHONE NUMBER
Cheque or Money Order - Payable to Camosun College
Debit
(in person)
Card#:
Expiry:
Card verication value (CVV):
Name of card holder:
Visa, MC, and JCB: The CVV security code is the
3 digits located on the reverse of the card
American Express: 4 digits on the front far right
C 0
Please indicate your preferred start date next to the checkbox for each level you want to register in. If you do not specify a start date you will be
registered in the next available seat. If your preferred section is full, you will be waitlisted for that section and registered in the next available section.
PROGRAM CHOICE
COLLECTION AND USE OF PERSONAL INFORMATION
DECLARATION
I understand and agree that it is my responsibility to schedule and register myself into the required technical training for my apprenticeship, and, if
applicable, in consultation with my Sponsor.
I certify the information provided in this application is true, accurate, current, and complete to the best of my knowledge and understand Camosun
College may verify accuracy. I agree, if admitted and enrolled at Camosun College, to comply with all policies and procedures.
I understand the application fee is non-refundable, is required from all applicants to a program and the application will not be processed until this
fee is received.
I understand and agree that acceptance of this application in no way guarantees enrolment and that this application is subject to the availability
of seats. I understand and agree the College reserves the right to modify or cancel any program or course without notice or prejudice.
Signature of Applicant Date:
PROGRAM YEAR 1 YEAR 2 YEAR 3 YEAR 4
Automotive Service Technician
Carpenter
Construction Craft Worker
(permission required)
Professional Cook
Diesel Engine Mechanic
Domestic / Commercial Gas Fitter
Electrician
Heavy Duty Equipment Technician
Metal Fabricator
Plumber
Refrigeration & A/C Mechanic
Sheet Metal Worker
Sprinkler Fitter
Steam/Pipe Fitter
Transport Trailer Technician
Truck & Transport Mechanic
Welder
Personal information is collected under the legal authority of the College and Institute Act, RSBC, 1996, c. 52 and s. 26 of the Freedom of
Information and Protection of Privacy Act, RSBC, 1996, c. 165 for administrative and statistical research purposes of the College, and/or the
ministries or agencies of the Province of British Columbia and the Government of Canada. The information that you provide is protected, used and
disclosed in compliance with these purposes. If you have any questions about the protection of your personal information, please review Camosun
College’s commitment to privacy, or email privacy@camosun.bc.ca
I authorize Camosun College to communicate and disclose my personal information regarding registration, attendance, progress, and related
enrolment information to:
• Industry Training Authority (ITA) and/or WorkBC;
• Ministry of Advanced Education and Skills Training; and
• The active employer Sponsor, or other agencies as appropriate
CONSENT TO DISCLOSURE
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Completed 18 September 2021

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