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Personal Information

Name First Last
Address
Street Address Address Line 2 City Province / State / Region Postal / Zip Code Country
Phone Number ### - ### - ####
MCP Number (Optional)
Date Of Birth MM / DD / YYYY
Maiden Name (If Applicable)

Next of Kin Information

Name First Last
Address
Street Address Address Line 2 City Province / State / Region Postal / Zip Code Country
Phone Number ### - ### - ####

Educational Background

Currently Attending High School?

Employment Background

Please provide the following detail of your last two (2) employers

Employer One
Employer Position Period of Employment
Employer Two
Employer Position Period of Employment

Enrollment Information

Preferred Starting Period
Preferred Starting Year
How Did You Hear About Keyin College?
Referred By
Select Campus
Select Program

Entrance Requirements

Successful completion of high school education or high
school equivalency diploma
Transcript and/or diploma to be forwarded to the College
Mature students who may not possess the educational
requirements or equivalencies and are 19 years of age
or older must complete an entrance exam to determine
their level of education
Completion of Keyin College’s official registration form
Completion of the College’s entrance exam
Registration fee of $50 which will be deducted from first
semester tuition (non-refundable 21 days prior to
commencement of classes)

Please note: Additional entrance requirements exist for
certain programs. For assistance or a complete list of
entrance requirements for a course of your choice, please
contact a Career Counsellor today.

Optional Information

Please indicate whether you intend to apply or have applied for any of the following sources of financing.

Canada Student Loan
HRLE
Workplace Health and Safety Compensation Commission (WHSCC)
Other Funding Source
Please indicate any medical condition(s) of which we should be aware
Email Address