OFFICE USE ONLY

Student No.
PLEASE PRINT CLEARLY / ALL APPLICABLE FIELDS MUST BE COMPLETED Program Code

I N T E R N AT I O N A L S T U D E N T A P P L I C AT I O N
1 PROGRAM CHOICE Date Payment
A) ENGLISH PROGRAM
Intensive English for International Students (IEIS) 4-month terms Indicate preferred start date: January May September

Other
B) CERTIFICATE, DIPLOMA, POST-GRADUATE DIPLOMA OR DEGREE (Check brochure or website for available start dates.)
international business
First choice Second choice

Indicate preferred start date: January May September Campus (if applicable)

2 PERSONAL INFORMATION
PARMPREET KAUR
Last/Family Name First/Given Name Middle Name
NEAR BABA BHAI HAZURI TAHLANI PATTI
Mailing Address
MANSA PUNJAB 148109 INDIA
City/Town Province/State Postal/Zip/Pin Code Country
7347059520 [email protected]
Telephone: Fax: Student’s Email (required)
99 INDIAN
Date of Birth / 06 / 29 Citizenship
YY MM DD

Gender Identity: Female Male Another Gender Identity (This may include Aboriginal Two-Spirit, Transgender, and other) Decline to Answer

EMERGENCY CONTACT:

First Name Last Name Telephone

3 EDUCATION HISTORY
SANT BABA LONGPURI ADARSH SENIOR SECONDARY SCHOOL INDIA
Name of attended High School (Secondary) Country

Graduation Type: ● Graduate Non-Graduate Still attending Last date attended: 05/2021
INDIA
Name of College/University (Post-Secondary) attended GOVT MAHENDRA COLLEGE PATIALA Country

Name of certificate, diploma or degree BACHELOR OF SCIENCE

Graduation Type: Graduate Non-Graduate Still attending Last date attended:

Name of College/University (Post-Secondary) attended Country

Name of certificate, diploma or degree

Graduation Type: Graduate Non-Graduate Still attending Last date attended:

PROOF OF LANGUAGE PROFICIENCY
6.5 20/02/2021
Language test: ● IELTS TOEFL CanTEST MELAB CAEL RRC Score: Date taken:

RELEASE OF INFORMATION

Education Agency

Agent Name Agent Email

Agent Mailing Address

Relative/Friend/Other (name) Email

I hereby authorize the College to release any of the following items: application information, admission status, Letter of Acceptance, transcripts, progress,
and attendance records (if applicable).
15/04/2021
Date Signature of Student in English (do not print)
 6 DECLARATION: PLEASE READ THE FOLLOWING BEFORE SIGNING.
1. I understand that the information I provide, including subsequent information placed in my student records, will be used for the purposes of admission,
registration, research, alumni and development and other purposes consistent with the mandate of the institution.
2. I understand that submission of this application does not guarantee admission to a program or course, and that admission is subject to meeting RRC’s
prerequisites and space availability.
3. I agree to abide by the rules and regulations of RRC as published, and those of the department and program in which I shall be registered, and any changes
that may be made while I am a student at RRC.
4. I certify that the information I have provided in this application is complete and accurate and may be verified by RRC. I understand that falsifying any
documents or information submitted will result in immediate cancellation of my admission or registration at RRC.
5. I understand that RRC has the right to cancel a program due to low registration.
6. I understand that RRC may send a copy of my Letter of Acceptance to Citizenship and Immigration Canada to verify its validity to assist with my Study Permit
application and communicate regarding student status.
7. I authorize RRC to disclose my information to the relevant organizations as requested by law.

15/04/2021

Date Signature of Student in English (do not print)

HOW DID YOU HEAR ABOUT RED RIVER COLLEGE?

● Agent Academic Advisor Career Fair Employer Family Friend Website Other

METHOD OF PAYMENT: FIRST PROGRAM: Intensive English: $100 CAD non-refundable application fee and $950 non-refundable tuition deposit ($1,050)
OR FIRST PROGRAM: Academic: $100 CAD non-refundable application fee and $300 non-refundable tuition deposit ($400)
Bank Draft or Money Order (payable to Red River College) Credit card: VISA MasterCard American Express
Applications will not be processed without the application fee and deposit.
5241930100401005 08/22 CVV:086
Card number Expiry date (mm/yy)
NIHARIKA GARG
Name on card Signature

Bank transfer Date of transfer Name of customer ordering bank transfer

Send a copy of the bank transfer receipt, with the student’s name clearly written, by fax to 204.632.5269 or email to [email protected]
FEES MAY BE TRANSFERRED ELECTRONICALLY TO:
Royal Bank of Canada, Main Branch
220 Portage Ave, Winnipeg, Manitoba Canada R3C 0A5
For Account: Red River College
Financial Institution 003, Branch number 00007, Account number 154-895-7, Swift Code: ROYCCAT2

SUBMIT THIS FORM TO:

APPLICATION CHECKLIST Remember to include the following: RED RIVER COLLEGE
International Education
✔
Complete Red River College International Student Application D210-2055 Notre Dame Ave,
✔
Original or certified English Language examination results (i.e., IELTS, TOEFL) Winnipeg, Manitoba, Canada R3H 0J9
✔
Original or certified academic documents (ie. transcripts and certificates).
IMPORTANT: For all documents that are not in English, certified
translated copies must be provided.
✔
Copy of passport identification page and study permit (if available)
✔
Application fee and deposit $1,050 (Intensive English) or $400 (Academic)
✔
Send by mail, courier or through your agent to Red River College www.rrc.ca/international
For further information: Phone 204.632.2143 Fax 204.632.5269 Email [email protected] or visit our website: www.rrc.ca/international
Red River College reserves the right to cancel a program. All dates, times, fees and locations are subject to change.
Printed in Canada, June 2014