Application for Admission Education Assistant Certificate 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/edassistant How to Apply 1. Submit the following documentation with completed application: Official High School Transcript and/or Post-Secondary Transcript A high school diploma or equivalent is a prerequisite for the program. All applicants are required to submit an official high school transcript. Students 21 years of age or older who do not have a high school diploma are considered on an individual basis pending space availability. Successful completion of English 30-1 or English 30-2 with 50% is necessary for admittance to the program. An official transcript must come directly to MRU from the issuing institution or remain in the original sealed envelope if submitted by the applicant 2. Include a non-refundable $100 application fee. Provide credit card number or make cheque payable to Mount Royal University. Do not send cash through the mail. 3. Submit the application package in one of the following ways: In Person: Mount Royal University, Lincoln Park Campus Continuing Education and Extension Registration Services 4825 Mount Royal Gate SW; Kerby Hall (East Gate) Room A101, Wickets 9 & 10 Call 403.440.3833 or toll free 1.877.287.8001 for current hours Mail: Mount Royal University Continuing Education and Extension Registration Services 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6 Fax: Continuing Education and Extension Registration Services 403. 440.6743 When to Apply Early Admission Fall Semester December 1 - April 30 Enrolment is limited. It is to your advantage to apply during the early admission period. Applicants who apply for early admission will be considered within 4-6 weeks of their date of application. Applications may be accepted after the early admission period, pending space availability. Visit the website for updates. Contact Information Website: Telephone: Toll-free: E-mail: conted.mtroyal.ca/edassistant 403.440.6867 1.866.616.3606 cehealth@mtroyal.ca Statement of Career Investigation 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/edassistant Education Assistant Certificate Please discuss the following topics in the space available. NAME: DATE: Why are you interested in becoming an education assistant? Why do you feel that being an education assistant would be a good career fit for you? What research have you done in order to adequately prepare yourself for this career? What experience have you had in education? Additional Comments (please attach an additional page if required): 4/3-/14 Application Form Education Assistant Certificate 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/edassistant PLEASE PRINT CLEARLY AND ANSWER ALL QUESTIONS COMPLETELY Have you previously applied to or have you ever attended Mount Royal University?  Yes  No If Yes, your Student ID number: Personal Information Last Name (family name) First Name (legal) Middle Name (legal) Previous Name (if applicable) Gender  Male Birth date dd mm yy  Female Mailing Address (Street/PO Box #) City/Town Province/Country Postal Code Telephone - Home Telephone - Business Fax (if available) ( ( ( ) Citizenship Status  Canadian Citizen  Landed Immigrant  Student Visa  Work Permit  Other ) Expiry date of your Visa (if already issued) dd mm yy ) Country of Citizenship _________________________________________ First Language (mother tongue) _________________________________________ English Language Proficiency requirement may apply E-mail Alberta Student Number (if available) Emergency Contact Name Telephone ( - - ) Previous Education Most recent High School Attended / Credential Earned City/Province From mm Post-Secondary Institution Attended / Credential Earned City/Province To yy mm From mm yy To yy mm yy Other 4/3-/14 Method of Payment ($100 application fee)  Cash/Debit (in person only)  Cheque (Mount Royal University)  VISA  MasterCard Card Number Expiry Date Cardholder's Name Cardholder's Signature  Money Order Applicant Survey How did you hear about the program?  Print (please specify):_____________________________________________________________________________________  Referral (please specify):__________________________________________________________________________________  Online (please specify):___________________________________________________________________________________  Other (please specify): ______________________________ ____ Why did you choose our program? ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Declaration Have you included:  Transcript  Statement of Career Investigation  Application Fee I certify that I have read all of the instructions and information accompanying this application form and that the information I have provided on the application form is true. Signature of Applicant _________________________________________________ Date ____________________________________________________ Freedom of Information and Protection of Privacy The information that you provide to Mount Royal University when you register for Continuing Education courses is collected under the authority of the Post-Secondary Learning Act and Freedom of Information and Protection of Privacy Act in the Province of Alberta, Section 33(c). This information will be used for academic administration, the administration of Mount Royal support services, scholarship and financial aid awards, marketing and recruitment activities. Your personal information is protected and can be reviewed upon request. The complete statement and further contact information is available at conted.mtroyal.ca/cefoip. 4/3-/14