Admission Form
e-Learning Technology Virtual University
Mill Cove Plaza, Bedford Highway Mid 48068
Bedford, NS - Canada B4A 3Z2
TEL: 1-902-832-1188 - FAX: 1-877-832-5131
ADMITTED Yes No
Academic Year Beginning on: ______ / / / Three Recent
Colour Photographs
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For EVU Use Only:_______________________________________________________________
Please make sure to fill the form completely, using block letters and writing clearly
First Name _________________________________ Family Name_________________________________
Full Name___________________________________________________________________________________
Home Permanent Address____________________ Mailing Address ______________________________
(if different) ___________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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Telephone #. ____________________________ Mobile #. ____________________________________
Fax: No. :_______________________________ e-mail address:________________________________
Date of Birth (Mo/Day/Yr)_________________ Married Single Male Female
Nationality_______________________________ Native Language______________________________
Current occupation/Position_________________________________________________________________
Proposed study at ETVU_________________________________________________________________
Financial Arrangements:
What kind of method you choose to pay your Fees?
_____________________________________________________________________________________
_______________________________________________________________________________________
Page (2)
Academic Qualifications
All applicants must enclose a transcript of their academic record, giving their marks or grades in each
year of their course, program of study.
No. Qualifications Subjects College/University + (City, Country) From To Awarded
Date
Please note: All applicants must provide proof of their qualifications.
Other Qualifications:
____________________________________________________________________________________________________
Professional Experience:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
Referees:
Mention names, titles, and full address of two referees who can inform the college of your academic
ability, your Character and your capacity for advanced study.
1.________________________________________ 2.________________________________________
_________________________________________ ________________________________________
_________________________________________ ________________________________________
_________________________________________ ________________________________________
Additional Information if any:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
How did you come to know ETVU? ____________________________________________________________________
This document is a form of application only. The University reserves the right to refuse admission to any candidate.
False or misleading information given on this form or academic credentials will result in rejection of the application
without refund fees.
When completed, this application and supporting documents should be sent to the Registrar office (by registered Air Mail)
Applicant Signature: _________________________________________________________Date:___ /___/______
www.e-education.ca/eTVU
