Program Application

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Personal Information

First Name*:

Last Name*:

Home Address*:

City*:

Province/State*:

Postal/Zip Code*:

Country*:

Email*:

Daytime Phone*:

Evening Phone:

For applicants within Canada or the USA, please supply your area code as well as your phone number and extension as follows:

1 + area code + phone number, extension

For applicants outside of Canada and the USA, please supply your country code and area code as well as your phone number and extension as follows:

1 + country code + area code + phone number, extension

Employer:

Job Title:

Employer Address:

City:

Province/State:

Country:

Are you a current or former student of UBC Continuing Studies? If yes, please enter your student number:

Education Background

List degrees, diplomas, certificates and any other qualifications you consider relevant to your application. You may be asked to provide documentation.

Qualification:

Institution:

Location:

Program/Major:

Year completed:

Qualification:

Institution:

Location:

Program/Major:

Year completed:

Other degrees/diplomas/certificates (include name, institution and year completed):

Online Program Applicants only:
(Project Management, Business Analysis, Program Management, Integrated Marketing Strategies)

Please list all courses you are currently enrolled in or which you have completed towards your certificate or award of achievement program. If you have not taken any courses, please leave blank:

Multimedia Studies Applicants only

Outline your computer experience and list the software programs you use frequently:

Work and Volunteer Experience

Insert your résumé or C.V. in a word-processed document in the box below. Please provide details about any work or volunteer experience you consider relevant to the program. Include the nature of the activity, the name of the company or agency you were associated with and the number of months or years of service.

Alternatively you may send your résumé/C.V. by fax to 604-822-1499.

Letter of Intent

Insert a letter defining your interests and program expectations, and the goals you expect to achieve upon completion of your UBC certificate. Please also comment on your level of knowledge and experience in your chosen field of interest (minimum: 300 words, maximum: 800 words).

References

List the names, phone numbers and emails of three professional or academic references. Indicate the nature of your relationship with each of them: *

All applicants, please fill out the following:

I understand that in order to fully participate in this program, I must have the following:

• an email account for communication with client services, instructors and students
• access to a computer system appropriate to the software of the program for which I am applying. In some cases, high-speed Internet access is desirable (the program handbook contains more details)
• the latest version of a reputable antivirus software program (e.g. McAfee VirusScan, Norton AntiVirus) installed on my computer. This is to protect the computer security of UBC students and instructors who will be communicating with me digitally throughout the program.

Yes, I understand and meet these requirements. *

How did you learn about the program* ?

UBC Continuing Studies calendar

UBC web sites

Ad (newspaper, magazine, etc.)

UBC Information Sessions

Friend or colleague (word of mouth)

Other   

Postcard or Brochure

Note: a confirmation email will be sent to you within three business days. If you do not hear from us in that time, please call 604-822-1420.

Personal information provided on the registration form is collected pursuant to section 26 of the Freedom of Information and Protection of Privacy Act (“FIPPA”), RSBC 1996, c.165, as amended. The information will be used for the purposes of: admission; registration; academic progress; notification of future courses; and operating other UBC-related programs. UBC collects, uses, retains and discloses information in accordance with FIPPA. UBC may share and disclose personal information within the University to carry out its mandate and operations. Information, in aggregate form only, may also be used for research purposes and statistics.

Should you have any questions about the collection of information, please contact Manager, Marketing Services, UBC Continuing Studies, 410-5950 University Boulevard, Vancouver, BC, V6T 1Z3.

We Respect Your Privacy
Your contact information is used to send you communications regarding upcoming UBC courses and events that may be of interest to you. Your contact information will not be released to others. If you check these boxes you will still receive communications relating to the administration of your course or program.

Please check here (check both if applicable) if you do not wish to be on our:
mailing list (if this box is checked, you will not be mailed our course calendar)
email list