Holland College | Application Form

Adult Education - Application Form

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Who can attend

The Adult Education program at Holland College is open to residents of Canada and international students. International students are required to pay an additional fee. All students must reside in the province of PEI to take courses with us.

What happens next?

We require a copy of your high school transcript with your application. It can be submitted to us at adulteducation@hollandcollege.com or have your high school fax it to us at 902-566-9688. 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), our academic advisor will review your application package and contact you via email to further discuss your career plan and a 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, program you want to apply to

If continuing your education, what institution

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 above or have any other learning concerns, you must contact Adult Education - Academic Advisor at 902-566-9362. Also, please forward any documentation of your learning or other disability to our academic advisor.

While Attending our Proram

Will you be working while attending our program?

How many hours a week are you working?

Are you planning to file for Employment Insurance (EI)

NOTE: You have indicated EI in the past or plan on filing for EI, we will send your completed application to Career Development Services (CDS). They will work with you so you are eligible to come to Adult Education and receive your EI. You will be contacted by CDS for an appointment. It is very important you attend the meeting so your application is not held up. If you have any questions about this process, we would be happy to go over it with you.

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

Citizenship Status

Country of Citizenship (If not Canadian)

English Language Proficiency

Is English your first language?

If no, have you completed an English proficiency test?

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

Students

Staff