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Medical Office Assistant / Unit Clerk
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Domestic Student Application
International Student Application
First name
Last name
Date of Birth
Email
Phone
Street Address
Postal Code
Social Insurance Number
City
Province
Are you a Canadian Citizen or Permanent Resident
Yes
No
Emergency Contact
First name
Last name
Relationship
Street Address
City
Province, State, Region
Postal Code, ZIP
Phone
Email
Program Information
Select your program
Select your program
Start Date
Preffered study time
Online (blended)
Weekend
Weekday
Evening
Education Background
Highest Level of Education You Completed
High School, GED, or equivalent
Collge/University
Other
Location
Degree/Diploma
How did you hear about CHBC?
How did you hear about CHBC?
I declare that the above information is true and correct. I understand that any false information submitted in support of my application may invalidate my application and result in withdrawal of a 'Letter of Acceptance and or Registration. I am authorizing CHBC representative or designate to assist or even to apply my loan to the Alberta Student Aid on my behalf I am willing to share my information to the College or designate. (Electronic Signature Acceptable)
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