Fillable Application for Admission

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Application for Admission

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The Application for Admission form is 3 pages long and contains:

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  • 6 check-boxes
  • 72 other fields

Country of origin: CANADA
File type: PDF

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PEN Number (Personal Education Number):
(Required for BC Grade 12 students, leave blank if you do not have one)
Application for Admission
This form is for domestic students applying to programs at Langara College. International students must complete an international
application. Applications for regular studies programs may also be submied online at www.langara.ca/apply.
Langara Identification Number:
(Leave blank if you do not have one)
PROGRAM
Please indicate the program you are applying for and the start month and year.
Program start dates vary, visit the program page at www.langara.ca or www.langara.ca/cs to learn more.
First choice program: Start Date:
Second choice program:
Start Date:
PERSONAL INFORMATION
Former last or family name:
Legal names are shown on your birth certificate or passport (if you didn’t legally change them later).
Legal first or given name:
Legal middle name:
Legal last or family name:
Woman Man
Choose not to disclose
Are you someone with trans experience? Trans experience means your gender identification does not align with the sex you were
assigned at birth.
Non-binary
Yes
Choose not to disclose
No
Country of citizenship:
Select status:
Canadian Citizen
Permanent Resident/Landed Immigrant
Other:
SELF IDENTIFICATION
Do you identify yourself as an Indigenous person of Canada as defined by Section 35, Powley, or Daniels?
Yes
If yes (optional):
First Nations
Métis
Community:
Inuit
Do you expect to receive sponsorship from your band?
Yes No
Band:
FOR DOMESTIC STUDENTS
IDENTIFICATION NUMBER
Preferred first name (optional):
Date of Birth:
Select your gender identity:
(YYYY/MM/DD)
Would you like to request transfer credit for previously completed post-secondary coursework? Visit the transfer credit page on
www.langara.ca to learn more and request transfer credit.
Do you wish to be contacted by an accessibility coordinator? Accessibility Services works with students with disabilities to arrange
appropriate support services on a case-by-case basis. (Optional)
Application for Admission
STUDENT CONTACT INFORMATION
Primary telephone: Alternate telephone:
Mailing Address
ACADEMIC RECORD (SECONDARY AND POST-SECONDARY)
If required, include proof of English language proficiency, such as English tests results (TOEFL, IELTS, LET, etc.), with your application.
For specific program requirements and supporting documents, check program webpage.
ADDITIONAL INFORMATION
Do you expect to be sponsored by an external funding organization?
If yes (optional),
name of sponsoring organization:
Yes No
Email address of applicant (Email is the primary form of communication from Langara):
Street address line 1:
Street address line 2:
City: Country: Postal Code:
Province/State:
Emergency contact name: Emergency contact phone number:
PREVIOUS SECONDARY AND
POST-SECONDARY INSTITUTION(S)
PROVINCE/COUNTRY
CREDENTIAL
EARNED
START DATE
DATE OF
GRADUATION
Contact person’s name (optional):
Contact’s email address:
I hereby authorize Langara to release admissions, registration, and tuition information to this organization. Yes
No
Have you lived as a youth in care in British Columbia? This is a voluntary declaration.
Yes No
Langara College and the Ministry of Children and Family Development may offer assistance with educational costs for eligible
students who are living or have lived as youth in care in British Columbia. Funding is subject to availability. Information on how to
apply, can be found online.
FOR DOMESTIC STUDENTS
Yes No
Yes No
Application for Admission
COLLECTION, USE, AND DISCLOSURE OF STUDENT INFORMATION
Langara College collects the information on this form under the authority of the College and Institute Act [RSBC 1996, Chapter 52, Sec-
tion 41.1]. This information isneeded, andwill be used, for purposes that are consistent with activity necessary to the operation of the
College and in compliance with the provisions of the Freedom of Information and Protection of Privacy Act [RSBC 1996, Chapter 165].
This information will be used for admission, registration, and maintenance of your student record. Information is shared with College
Advancement and the Langara Students’ Union.
DECLARATION OF APPLICANT
By submiing this form I certify that a) I am the person named in the “Personal Information” section above, or I am an agent acting
on behalf of the applicant with their permission, b) I agree to the following:
• All statements on this application and supporting documents are true and complete.
• I authorize Langara College to verify any information provided as part of this application.
• I understand that evidence of falsified documents or misrepresentation will result in the cancellation of my admission or
registration.
• I understand that information about falsified documents is shared with other Canadian colleges and universities.
• I understand and acknowledge that it is my responsibility to be aware of, and comply with, all Langara College policies and
procedures.
• In consideration of Langara College permiing me to participate in any program, I hereby release Langara College, its officers,
employees, servants, agents, contractors, and subcontractors from any and all claims and waive any and all claims I may have
now or in the future against Langara College, its officers, employees, servants, agents, contractors, and subcontractors that
arise out of or are related in any way to my involvement in any program and all associated activities.
• Admission is subject to assessment of qualifications and availability of seats. Admission to the College does not guarantee the
availability of any individual course.
Print name:
Date:
FOR DOMESTIC STUDENTS
For questions about the collection, use and disclosure of your personal information, contact Registrar & Enrolment Services at
604.323.5241 or the Dean of Continuing Studies at 604.323.5322.
The personal information you provide on this form may be shared with the Ministry of Education and will be used to verify your
British Columbia Personal Education Number (PEN) or assign one to you. The personal information you provide and your PEN are
used for authorized statistical and research purposes only.
APPLICATION CHECKLIST
Application fee (Note 1)
Complete application form
Official score report of English language test, if applicable
Official transcripts and graduation document(s) with certified English translations
Submit completed application form with supporting documents and correct fee:
• Online through www.feeportal.langara.ca (search for Domestic Application)
• In person, with cash, cheque, Visa or MasterCard: Registrar and Enrolment Services (1st floor T building)
• By mail with cheque: Registrar & Enrolment Services, Langara College 100 West 49th Ave, Vancouver BC V5Y2Z6
Note 1: The application fee is non-refundable. Please refer to Langara’s refund policy regarding all other fees. Visit www.langara.ca to
learn more.
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Application for Admission

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Completed 29 September 2020

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