Student Equipment Application

New Student Agreement?

Yes No

Extension of the existing agreement?

Yes No

Online Learning Centre:

Student Information

Name:

CRM Client ID:

Phone:

Cell:

Email:

Home Address:

City:

Apt Number / Buzzer Code:

Postal Code:

Laptops and modems cannot be delivered to a Post Office (P.O. Box). Other arrangements may be available.

Student Course Information

Program Name:

Program Duration (expected graduation date/month):

Institution:

Course(s) (Subject):

Course Start Date:

Course End Date:

Extension of the existing agreement (list new courses)

Institution:

Course(s) (Subject):

Course Start Date:

Course End Date:

Equipment Requirements

Laptop?

Yes No

Modem? (must have access to Bell, Rogers, Tbaytel or Shaw Networks)

Yes No

Microsoft Office 365 Online is included with each student account for the duration of the equipment loan (includes access to Outlook, Word, Excel, PowerPoint, and OneNote online, does not include Office Desktop.

Student Equipment Application

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