Individual Applicant Registration

Please complete the form to register.

* Denotes Required fields

This username is already taken
Please re-submit the form below and make sure you select a new username."; } elseif ($_GET["error"] == "mismatch") { echo "
Password did not match
Please re-submit the form below and make sure you correctly confirm your new password.
"; } elseif ($_GET["error"] == "emailexists") { echo "
This email address has already been registered
Please re-submit the form below using another email address.
"; } ?>
1. Login Information

Select a Username and Password for your account


Username*:
Password*:
Confirm Password*:

2. Student Information

Complete the fields below with your Student Information


First Name*:
Last Name*:
Email Address*:
Address*:
City*:
Province*:
Country*:
Postal Code*
Phone*:
Education completed:
Preferred Employment:
3. Sponsor/Employer Information

(If you are sponsored, please Enter your sponsor/employer information)


Sponsor: