Application Form for Individual (Open Entry) Courses

Student Number

*Primary Email Address

UNB Email Address (If you are a current UNB student.)

*First Name

*Middle Name

*Last Name

*Street Address

*City

*Province, Territory or State

*Country

*Postal Code

Address while attending UNB (please choose one)

Same Address Different Address

Telephone Numbers

Home Phone Number

Work Phone Number

Mobile Phone Number

General Information

Have you ever been required to withdraw from any post-secondary institution, including UNB

Yes No

Gender

Male Female

*My mother tongue is

*Status in Canada

Canadian Student Visa Permanent Resident Other - please specify:

Permanent Residents must submit a copy of the front and back of their permanent residence card prior to completion of registration. This can be emailed to extend@unb.ca or faxed to 506 453-3572

*Country of Citizenship

*Birthday

New Students

Have you taken any classes with us before, or applied to UNB in the last year

Yes No

Institutions previously attended (including UNB)

Name of school(s)

City or Town

Province

Country

Dates

How many courses do you wish to take

Do you plan to complete a program at UNB, or is this a course for interest

Degree/Certificate Program Information

Program Admittance (Please choose one)

I have not been admitted to a Degree/Certificate Program at UNB
Course Information Follows

I have been officially admitted to the Degree/Certificate Program

I was previously registered at UNB in the year

I am a Registered Nurse

Yes No

Are you a Full-time or Part-time Student at UNB

Full-time Part-time

How did you hear about Online@UNB

Brunswickan Ad
Alumni News
Local Newspaper
Web site
Campus Canada
Canadian Virtual University
Campus Connection
Calendar
Faculty Member
Friend
Other, please specify:

Course Information - Course Designation

Text book cost are in addition to the course fees and the books may be purchased from the UNB Bookstore.

Non-Canadians must add the fee differential for each three credits of the above courses. (All prices are listed in Canadian currency.)

I wish to apply for

ADM1213 ADM1313 ADM2223 ADM2815 ADM3315 ADM3345 ADM3445 ADM3815 ADM4326 CE3963 CHE2418 CHE2501 ECON1001 ECON1013 ECON1023 ECON1073 ECON3013 ECON3023 ECON3103 ECON3505 ECON3705 ECON3775 ECON3865 EE6913 ENGL1144 ENGL1145 ENGL1146 ENGL2901 ENGL2902 ENGL3250 FOR1285 FOR2285 FOR2286 FOR6281 FOR6282 FOR6304 LAT1103 MATH0863 MATH1013 MATH1503 PHIL1101 PHIL1201 PHIL2201 PHIL2203 PHIL2207 PHIL3203 PHIL3206 POLS1000 POLS1603 POLS2373 POLS3614 PSYC1013 PSYC1023 PSYC2203 PSYC2313 PSYC2403 PSYC2603 PSYC2703 SOCI3634 STAT2263 TME3313

Additional Comments

Privacy Policy

The personal information requested on this form is collected in relation to and is needed by the University of New Brunswick for the purposes registration in online courses, and will, upon registration, form part of your student record under the authority of the University of New Brunswick Act.

Your student record may be used and disclosed as provided for in the University Regulations, Section X, Confidentiality, Security, and Release of Academic Records.

If you have questions or concerns regarding privacy or management of personal information at UNB, you can consult www.unb.ca/privacy