Application for Admission FormsApplication for Admission • June 12th, 2004
Contract Type FiledJune 12th, 2004NAME Last (Family) Name First MiddlePlace PhotoAppt. # Number / Street Here City Prov / State Postal CodePh ( ) Ph. ( ) Home Work SEX: Male Female Month / Day / Year Citizenship Email Address Name (contact in case of emergency) Relationship to you ( ) Number/Street City Prov / State Postal Code Phone Number PRESENT ADDRESS PHONE BIRTH DATE EMAIL EMERGENCY CONTACT PROGRAM One Year Omega Challenge Two Year Certificate in Three Year Diploma in Four Year Degree in Other Full Time (12-17 sem. hrs.) Part Time (1-11 sem. hrs.) Audit (non-credit) YES Single *Married * (submit written request to Business Administrator). NO Residence plans COURSE LOAD ON CAMPUS RESIDENCE MARITAL STATUS Single Married *Widow(er) *Separated *Divorced *Remarried * Please cover in Personal History. For SINGLE Applicant: Father's Name Mother's Name Address: Same as home address above Other Number/Street City Prov / State Postal Code Father's occupation Mother's occupation Are your parents Christians? Yes No
Application for Admission FormsApplication for Admission • June 12th, 2004
Contract Type FiledJune 12th, 2004PO Box 1700Abbotsford, BC V2S 7E7 Phone: (604) 853-7491FAX: (604) 853-8951 ($50.00 Application Fee Required)This application is to be completed by the applicant FOR OFFICE USE ONLYApp. Rec.: Pd. App. Fee: Accepted: I.D. Number: Have you previously applied to Summit Pacific College? Yes Date: No: If accepted, you plan to attend: Fall 20 Spring 20 Last (Family) Name First Middle Apt. # Number / Street City Prov / State Postal CodePh ( ) Ph. ( ) Home Work Email Address CitizenshipBirth Date: Male Female Month / Day / Year Place Photo Here Name Relationship to you ( ) Number/Street City Prov / State Postal Code Phone Number One Year Omega Global One Year Certificate in Two Year Certificate in Three Year Diploma in Four Year Degree in Other Full Time (12-17 sem. hrs.) Part Time (1-11 sem. hrs.) Audit (non-credit) On Campus: Single *Married * (submit written request to Director of Finance).Off Campus: Residence PlansSingle Married *Widow(er) *Separated *Divorced *Remarried * Please