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LIFESKILLS & AQUATICS REGISTRATION FORM - AUTUMN 2009

Please Register Online at: www.vaniercollege.qc.ca/conted or use this Form

Use this Form for LifeSkills or Aquatics Courses

Last Name:

LifeSkills/Aquatics File Number

_

First Name:

Male Female

Date of Birth:

Postal Code:

Address:

year Apartment:

month

day

City:

Province:

Primary Telephone #:

Other Telephone #:

Work Telephone #:

Email address:

Parent/Guardian Name: (For Aquatics Program)

Parent/Guardian Date of Birth:

Course Selection

year

month

day

Section No.

-

A

0

9

MEETING DATES:

-

A

0

9

TITLE: MEETING DATES:

Section No.

-

A

0

9

TITLE: MEETING DATES:

3.

2.

I would like to register for the following courses:

1.

Section No. TITLE:

COURSE FEES:

COURSE FEES:

COURSE FEES:

NOTE: If you register by mail or fax, you will receive confirmation by mail once your registration has been processed. Only properly completed registrations will be processed. All fees must be paid in full at the time of registration.

Semester Parking Permit

LIFESKILLS and/or AQUATICS FEES = $ PARKING FEES (if applicable) = $ TOTAL = $

If you wish to purchase a semester parking permit, please complete the following. Each permit costs $30.00 per evening for the semester. (Nightly parking after 5:00pm is also available at a cost of $4.00 per individual evening. Tickets are available at the Parking Pay Stations.) There is no charge for parking on Friday evening, Saturday or Sunday.

Vehicle Information Make of Vehicle:

Student Signature: Date:

COURSE WITHDRAWAL & REFUND: The College reserves the right to cancel courses due to low enrolment. Students will be informed if a course is cancelled. The student may then choose either to take another course or receive a full refund. Students wishing to withdraw from a course must notify the Centre for Continuing Education in writing, stating the name of the course, before the first scheduled meeting of the course. The refund consists of the course fee less $20. THERE IS NO REFUND AFTER THE FIRST SCHEDULED MEETING.

Colour of Vehicle:

Method of Payment

Licence Plate #:

No cash or personal cheques are accepted.

Parking Permit Information For which evening do you want the Parking Permit?

Monday Student Signature: Tuesday

Wednesday

Thursday

Date: Office Signature:

MasterCard Money Order Card No.: Expiry Date: Card Holder Na

me:

VISA

Certified Cheque

Debit Card (In Person Only)

Card Holder Signature: Date:

FOR OFFICE USE ONLY Parking Permit Number(s):

Monday

Total Fees Paid: $

Method of Payment:

Tuesday

Wednesday

Thursday Date:

Refund Information Student withdrew from course Permit #

Course was cancelled by College Returned on

VANIER COLLEGE CONTINUING EDUCATION • 815 Ste-Croix Avenue, St-Laurent, Québec H4L 3X8 • Tel: 514-744-7000 • Fax: 514-744-7017 www.vaniercollege.qc.ca/conted

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