Childbirth Educators - Level 1 Courses

Pre-Admission Assessment Application Form

Please complete then print the following form. Send the Pre-admission Assessment fee of $35.00 along with a copy of the completed form. Make the cheque payable to Humber College.

Applications are accepted all year round

Mail To:
Program Coordinator, Maternal Child Programs
Continuing Education, Nursing, School of Health Sciences
205 Humber College Blvd., Etobicoke, ON M9W 5L7

All applications must be accompanied by:

Copy of the official transcript of undergraduate/postgraduate education

Resume

References (May be requested)

Letter stating reasons for seeking certification

Assessment Fee ($35.00)

Questions regarding prior learning should be directed to the Program Coordinator at the above address or by phoning (416) 675-6622 ext. 4078 or by e-mail at sylvia.segal@humber.ca

Name:

Address:

Street:
City:

Province:
Postal Code:

Telephone Number: Home

Telephone Number: Business

E-mail Address: </td> </tr> <tr> <td>Humber College Registration Number (if applicable):</td> <td><input type="text" name="regnumber" id="regnumber" /></td> </tr> <tr> <td>Please tell us how you heard about this program:</td> <td><textarea cols="30" rows="8" name="message">

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