FACULTY OF CONTINUING
EDUCATION & TRAINING
Admission Request Form
PLEASE CHECK ONE: PRACTICAL NURSING PROGRAM
OPTICIANRY PROGRAM
SENECA Student ID: ______________________________________
Last Name: _______________________________________ First Name: _____________________________________
Street Address: ____________________________________ Apt./Unit #: __________________
City: __________________________ Province: ________________________ Postal Code: _______________________
Home Phone: ________________________________ Other Phone: ________________________________
Seneca Email: ________________________________ Other Email: ________________________________
Listed below are entry requirements to process this application. PROOF of attained credits must be attached.
Requirement
Name of attached supporting document or transcript
English: Grade 12 (C) or ENG4 (U) or College English
Physics or Chemistry Grade 12 (C)
Mathematics Grade 11 (U) or (M) OR Grade 12 (C)
Biology Grade 11 (C)
Signed: ______________________________________ Date: ____________________
FREEDOM OF INFORMATION AND PROTECTION OF
PRIVACY ACT
Personal information on this form is collected in accordance with sections 21,
39 and 49 of the Freedom of Information and Protection of Privacy Act and
under the legal authority of the Ministry of Training, Colleges and Universities
Act, R.S.O. 1990, and the Ontario Colleges of Applied Arts and Technology
Act, 2002, Regulation 34/03, and may be used and/or disclosed for
administrative, statistical and/or research purposes of the College and/or the
ministries or agencies of the Government of Ontario and the Government of
Canada. If you have any questions concerning the collection and use of
personal information, please contact the Privacy Office at (416) 491-5050
extension 77846 or email privacyoffice@senecacollege.ca.
Faculty of Continuing Education OFFICE USE ONLY:
Please date stamp and forward to: Maria Graziosi, Program Assistant
Initial
below
I confirm my understanding of the following:
I will be notified of acceptance into the program by email.
I must receive the confirmation letter of acceptance (by email) and will be invited to attend an information
session BEFORE registering for professional Opticianry or Nursing specific subjects at Seneca. (I may
register for general education subjects at any time.)
If transferring professional Opticianry or Nursing subjects from another institution, I may only apply for
advanced standing credit for professional subjects AFTER receiving my formal letter of acceptance by
email. (General Education subjects may be transferred at any time.)
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