Indigenous Education Program Application Form

If you are unable to submit or access this form, click here to download and save a PDF version.

Program

Please indicate your intended program of study

Indigenous Classroom Assistant Diploma Program (ICADP)

Indigenous Teacher Education Program (ITEP)

Teacher of Indigenous Language as a Second Language (TILSL)

Enrollment

Have you previously enrolled at Nipissing University?

Yes

Last Program

Nipissing Student ID/Number

Last Semester

Have you taken any courses at a post-secondary institution since your last registration at Nipissing University?

Yes

What institution(s)?

Last Secondary School Attended

From

Name of School

Grade Completed

Diploma Received?

Yes

All Post-Secondary Institution(s) Attended

From

Institution

Program

Degree / Diploma

From

Institution

Program

Degree / Diploma

Employment or Activities When Not a Full-Time Student

From

Employer or Nature of Activity

Job Title / Description

From

Employer or Nature of Activity

Job Title / Description

Acknowledgement

I hereby certify that all statements are correct and complete including my declaration of citizenship and status in Canada. I understand that I may have to provide documentation at some future date to substantiate my claim and that misrepresentation of this data may result in the cancellation of my admission or registration status.