Student Enrolment Contract ‐ Approved Program

Voluntary Disclosure

You may voluntarily provide the personal information listed below:

Do you identify yourself as and indigenou person, that is, First Nations, Metis, or inunit?

If your answer is "Yes", please indicate if you are?

First Nations
Metis
Inunits

Do you have a long-term physical or mental health condition that limits the kind of activity that you can perform on a daily basis?

Program Information

Program Title

Program Title is Required

Hours of instruction during contract term

Hours of instruction during contract term is Required

Program Duration in Weeks

Program Duration in Weeks is Required

Contract Start Date

Program Duration in Weeks is Required

Contract End Date

Credential Issued on Graduation

Diploma
Certificate

Program Delivery Method (select all that apply)

In-Class
Distance
Combined

Language of Instruction

Student Declaration

I consent to the sharing, in accordance with Provincial privacy legislation, of my enrolment and reporting information between MMI Academy and Immigration, Refugees and Citizenship Canada, as necessary, for the purposes of the International Student Program.

Should you have any questions about the collection, disclosure and use of personal information you may contact us.

Student Signature *

Use your cursor or finger to draw on the signature box.

Please provide your digital signature

Date Signed *

Date Signed is Required