Holland College

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Adult Education - Application Form

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Who can attend

All Adult Education students must be a Canadian citizen or Permanent Resident, and reside on PEI to attend our program.

What happens next?

We require a copy of your high school transcript with your application (unless applying for the GED program). It can be submitted to us at adulteducation@hollandcollege.com. If you have completed your GED, language proficiency tests and/or post-secondary courses, these transcripts should be forwarded to us as well.

Once we have received your application and transcript(s), if applicable, our academic advisor will review your application package and contact you via email to further discuss your course schedule.

Education History

Are you 18 years of age or over?

Have you been out of the public school system for at least one year?

Have you graduated from High School?

What was the last grade you completed?

If you have taken GED, do you have your GED certificate?

How did you hear about our program?

Have you attended Adult Education in the past?

Personal Information

Last Name

First Name

Middle Initial(s)

Previous Name (If applicable)

Address

City

Province

Postal Code

Phone Number

Other Phone Number

Email AddressWe will be corresponding with you via email. Please ensure this address is secure and accessible.

Date of Birth

Social Insurance Number

Adult Education Location

Location you want to attend

Are you interested in

Career goal or post-secondary program you want to apply to

If continuing your education, what college or university are you applying to

Courses you wish to take in Adult Education

Students with Learning requirements

Completion of this section is mandatory and will remain confidential.

Do you have any special physical or learning requirements for your study at Holland College?

If you have selected YES, please forward any documentation of your learning or other disability to our Academic Advisor.

While Attending our Proram

NOTE: Students who are or will be receiving funding, must work with a Service Provider or you will jeopardize your benefits. We will forward your application and you will be contacted for an appointment.

Are you planning to file for Employment Insurance (EI)

Please explain your choice in more detail

Are you currently receiving benefits from any of the following sources:

Will you be working while attending our program?

How many hours a week are you working?

Citizenship Status

Country of Citizenship (If not Canadian)

English Language Proficiency

Is English your first language?

If you would like to schedule an English proficiency test and reside in PEI, please contact Diana Garnhum at degarnhum@hollandcollege.com

Release Information

Permission is hereby granted to Holland College to exchange personal information from my file with SkillsPEI, Provincial and Federal Government Departments and Agencies, or their representatives and/or other bodies, for statistical and management purposes, related to the goals and objectives of the training/educational program. I hereby release the College and these other departments, agencies and bodies from any and all liability in connection with the release of this information.

I certify that all statements on this application are true and complete. I understand that any misrepresentation may result in the refusal, cancellation or withdrawal of funding, the refusal or cancellation of my admission, or my dismissal from the college.

I understand that my application will not be complete until I submit an up-to-date high school transcript.

I understand that my application is conditionally accepted by Adult Education pending availability of seats and/or funding approval.

Acknowledgement: I understand that by submitting my application, I am authorizing Holland College to collect, use and disclose my personal information, as described in the Privacy Statement for Students.

I hereby certify that all information on my application is true and complete. I understand that by continuing with my application process I am granting permission to Holland College to contact me regarding my application. I understand that false information may result in cancellation of my admission or dismissal from the college. I agree that any misrepresentation by me may be shared with other post-secondary institutions. For more information on Privacy at Holland College visit our privacy webpage:
https://www.hollandcollege.com/privacy_policy.html

I agree