The United Theological College Le Séminaire Uni 3521 rue University, Montréal, QC H3A 2A9 Online Course Application Form 1. 2. Name: _____________________________________________________________________________ Address: _____________________________________________________________________________ City / Prov: ___________________________________ Phone: (Home) ______________________________ (Work) __________________________________ Email: _____________________________________________________________________________ Postal Code: ________________________ Name of Course for which you are applying: _____________________________________________________________________________________________ Course Dates: ______________________________________________________________________________ 3. Have you taken previous courses in this program? No Please include with your application the following documents: Transcript of previous academic work Yes 4. Please skip to section 5. to complete your registration for this course. Course Requirements: a) Applicants must be able to demonstrate proficiency in English to undertake course work. (Please review the language requirements the UTC college website – www.utc.ca) b) Applicants should already have an undergraduate degree (B.A. or equivalent). Academic Background: Please indicate which academic program(s) you have already completed: i) _________________________________________ Completion date: ____________________ Degree/Diploma _____________________________ Institution: _________________________ ii)_________________________________________ Completion date: ____________________ Degree/Diploma _____________________________ Institution: _________________________ 5. Do you have a particular goal or objective (personal or professional) in taking this course? ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ 6. Payment: Cheques should be made payable to: The United Theological College. 7. Signature of Applicant: ___________________________________ Date: ______________________ Please send this application form to: The United Theological College / Le Séminaire Uni 3521 University Street Montreal, QC H3A 2A9 or send by email to the Administrative Office at admin@utc.ca For office use only: Application Received: ___________________________ Application Approved: __________________________________