Indigenous Canadian Relations Certificate Application

There is a $30.00 fee to register for the Indigenous Canadian Relations Board of Governors’ College Certificate which will be applied to your student account. You will not be registered into the program until payment has been received.

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Student Number

Last Name *

First Name *

Campus *

Address *

City *

Prov *

Postal Code *

Home Telephone *

Alternate Telephone

E-mail *

Disclaimer

I understand and agree that by submitting this form, it is the equivalent of my electronic signature and will be treated as if a signed form was submitted to Registrar's Office.

Date *

Electronic Signature *

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Indigenous Canadian Relations Certificate Application