Certificate Request Form - St. Francis Xavier University

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The Certificate in Adult Education is awarded upon completion of the five classroom
modules/required assignments of the Diploma in Adult Education program.
We issue the certificate (by mail) once we receive this (completed) form:
NAME TO BE INSCRIBED ON THE CERTIFICATE (please print)
______________________________________________________________________________________
ID # ___________________________________________________________________
MARKS RECEIVED FOR
MODULE 1_______
MODULE 4 _______
MODULE 2 _______
MODULE 5 _______
MODULE 3 _______
DATE OF FINAL MODULE ________________________
MAILING ADDRESS:
Return to:
LOCATION __________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
•
dipaded@stfx.ca) … OR
•
fax: 902-867-2486 … OR
•
Diploma in Adult Education
St. Francis Xavier University
2175 Varsity Dr., MacDonald Hall
Antigonish, NS
B2G 2W5
Congratulations and best of luck with your practicum.
Wm. Goggin
Director, Diploma in Adult Education
Diploma in Adult Education, StFX, 2012
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