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Vuc - Application For Admission

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                         Admission Form

e-Learning Technology Virtual University


                                                        Mill Cove Plaza, Bedford Highway Mid 48068
Bedford, NS - Canada B4A 3Z2
TEL: 1-902-832-1188 - FAX: 1-877-832-5131

ADMITTED Yes No

Academic Year Beginning on: ______ / / / Three Recent


Colour Photographs
________________________________________________________________________

For EVU Use Only:_______________________________________________________________

Please make sure to fill the form completely, using block letters and writing clearly

First Name _________________________________ Family Name_________________________________


Full Name___________________________________________________________________________________
Home Permanent Address____________________ Mailing Address ______________________________
(if different) ___________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Telephone #. ____________________________ Mobile #. ____________________________________

Fax: No. :_______________________________ e-mail address:________________________________


Date of Birth (Mo/Day/Yr)_________________ Married Single Male Female
Nationality_______________________________ Native Language______________________________
Current occupation/Position_________________________________________________________________

Proposed study at ETVU_________________________________________________________________

Financial Arrangements:

What kind of method you choose to pay your Fees?


_____________________________________________________________________________________

_______________________________________________________________________________________
Page (2)

Academic Qualifications

All applicants must enclose a transcript of their academic record, giving their marks or grades in each
year of their course, program of study.

No. Qualifications Subjects College/University + (City, Country) From To Awarded


Date

Please note: All applicants must provide proof of their qualifications.

Other Qualifications:
____________________________________________________________________________________________________

Professional Experience:
____________________________________________________________________________________________________
____________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

Referees:
Mention names, titles, and full address of two referees who can inform the college of your academic
ability, your Character and your capacity for advanced study.

1.________________________________________ 2.________________________________________
_________________________________________ ________________________________________
_________________________________________ ________________________________________
_________________________________________ ________________________________________

Additional Information if any:


__________________________________________________________________________________________________
__________________________________________________________________________________________________

How did you come to know ETVU? ____________________________________________________________________

This document is a form of application only. The University reserves the right to refuse admission to any candidate.
False or misleading information given on this form or academic credentials will result in rejection of the application
without refund fees.
When completed, this application and supporting documents should be sent to the Registrar office (by registered Air Mail)

Applicant Signature: _________________________________________________________Date:___ /___/______

www.e-education.ca/eTVU

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