Fillable Form 3: Continuing Education Registration Form f f (Mohawk College)

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Form 3: Continuing Education Registration Form f f (Mohawk College)

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The Form 3: Continuing Education Registration Form f f (Mohawk College) form is 1 page long and contains:

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  • 17 check-boxes
  • 37 other fields

Country of origin: CANADA
File type: PDF

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If you know your Mohawk College ID, enter it here:
f f f f f f f f f
f f
Did you have a previous last name? If so, include it here so we can match your student record. Previous Last Name
Date of Birth
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Ontario Education Number (OEN)
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(Eg. 01 / Jan / 1968) Day Month Year
f f f f f
f f
Last Name First Name Middle Name (full - not initial)
Unit/Apt Street Address
City Province Postal Code
Home Phone Business Phone Ext.
Personal Email Address
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CRN Course Code Course Name Campus Start Date FEE
CRN Course Code Course Name Campus Start Date FEE
CRN Course Code Course Name Campus Start Date FEE
f f
TOTAL FEE
f f
If yes, Program Name Program Number
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f f f f
$
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This document contains both information and form fields. To read information, use the Down Arow from a form field.
Continuing Education Registration Form
Use this form if you are registering by Email. Email completed form to cereg@mohawkcollege.ca
Have you been a previous student at Mohawk? Yes No
Are you a Canadian Citizen, Indigenous or Landed Immigrant? Yes No Gender
3
: Male Female Other/Prefer not to disclose
Do you possess a high school Diploma? Yes No
Mr Mrs Ms Miss
Course Information Use this to register for up to 3 courses. Courses with insufcient enrollment will be cancelled before the course starts. It is recommended that you
register at least one week prior to the course start date.
Should requested CRN’s be full, please add my name to the Wait List: Yes No
Are you working towards a Certicate or Diploma? Yes No
Payment Information
4
Course fees must be paid in full at the time of registration
Payment must be made via MyMohawk. DO NOT SEND YOUR CREDIT CARD INFORMATION BY EMAIL.
1-3 Date of Birth, Ontario Education Number (if known) and Gender are required on the Mohawk College Student Record System to assist in the retrieval of your academic grades; to issue
income tax receipts; and, to conrm your Ontario Education Number (OEN).
4 International Students - Unless Mohawk has proof of your valid health insurance, you will be billed health insurance fees after you register for your course(s).
PRIVACY AND CONFIDENTIALITY: Mohawk College collects and retains personal information in compliance with the Freedom of Information and Protection of Privacy Act (RSO 1990). See the
Privacy Statement at mohawkcollege.ca/legal.
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Form 3: Continuing Education Registration Form f f (Mohawk College)

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Completed 5 February 2021

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