Greenhouse Practices and Operational Fundamentals Registration Form

Step 1 of 4 – Student Information

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Phone

This field is for validation purposes and should be left unchanged.

Name(Required)

First Middle Last

Email(Required)

Phone(Required)

Date Of Birth(Required)

MM slash DD slash YYYY

Social Insurance Number*

* Required for all students eligible to receive a Tuition and Enrolment Certificate (T2202) under the authority of the Income Tax Act. Submitting your SIN does not automatically qualify you for a T2202 certificate. See Tuition and Enrolment Certificate (T2202) for more information

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name

Emergency Contact Phone

Practicum Placement(Required)

Fernie

Invermere

Practicums will be offered in Fernie and Invermere. We will try our best to accommodate your preference.

Gender Identity(Required)

Woman – People whose current gender is woman. This includes cisgender and transgender people who are women.

Man – People whose current gender is man. This includes cisgender and transgender people who are men.

Non-Binary Gender – People whose current gender is not exclusively a woman or man. This includes people who do not have one gender, have no gender, are gender fluid, or are Two-Spirit.

Prefer Not to Answer/Unknown

Would you say you are(Required)

Cisgender – People whose sex assigned at birth is the same as their gender

Transgender – People whose sex assigned at birth is different from their gender.

Prefer Not to Answer/Unknown

Volunteer Disclosure – Do you identify yourself as an Indigenous person of Canada?

Yes

If yes, check all that apply

First Nations

Metis

Inuit

Status

Non-Status

Primary Language

English

French

Mandarin

Spanish

Hindi

Other

Citizenship Status – Are you a Canadian citizen?(Required)

Yes

If NO, what is your country of citizenship

Status

Permanent Resident

Minister’s Permit

Diplomat

Live-in Caregiver

Refugee (status granted)

Other

Do you have at least 3 years of work/volunteer experience?(Required)

Yes

Other status

Have you previously attended College of the Rockies?(Required)

Yes

Student Number (if known)

Current Employment Status(Required)

Employed Full-Time

Employed Part-Time

Self-Employed

Unemployed

Student

Please note that there are a limited number of subsidies available to cover the $200 contribution fee for equity-deserving participants. Do you identify as having lived experience in one or more of these equity[1]deserving groups? (Women, Persons with disabilities, Indigenous Peoples, Racialized individuals or visible minorities, Newcomers or 2SLGBTQIA+ community members.)

Yes

If you answered yes, would you like to be considered for this subsidy on a first applied, first served basis?

Yes

Consent PLEASE REVIEW(Required)

I agree to the privacy policy.

Your personal information is collected, used, and disclosed by your academic institution under the Freedom of Information and Protection of Privacy Act (FIPPA) sections 26(c), 26(e), 27(1)(b), 27(1)(c)(i), 32(a), 32(b) and 33(2)(d). This information will be used by your institution to manage, administer, and report on program enrolments, completions, and evaluate applications for scholarships, bursaries, and awards.

By submitting this form:

I understand that the personal information on this form is collected under the authority of the College and Institute Act. I understand the information collected on this application is consistent to the Freedom of Information and Protection of Privacy Act and will be used confidentially for purposes of admission, registration, student support services, research, alumni relations, administration of the Student Association fees and other purposes consistent with the mandate of the College. In providing the College with an email address, I acknowledge that the College may send confidential information about me to this address. Any questions I have concerning the collection and use of this information should be directed to the Registrar’s Office.

Providing your consent to have your personal information, including your Social Insurance Number, disclosed to, and used by, BC provincial ministries and CRA.

Questions about the collection of this information may be directed to studenservices@cotr.bc.ca