Printable Registration Form

Please make copies if applying to more than one course – USE ONE FORM FOR EACH COURSE!

PERSONAL INFORMATION

First Name: _______________________

Last Name: _______________________

Address: _________________________

City: ____________________________

Province / State:___________________

Postal Code: ______________________

Country: _________________________

Home Phone: (___)_________________

Home Fax :(___)___________________

Company:__________________________

Address:___________________________

City: _____________________________

Province / State:____________________

Country:__________________________

Postal Code:_______________________

Title/Position:______________________

Business Phone: (___)________________

Business Fax: (___)__________________

Email:_____________________________

COURSE(s)

(please use one page per course registration)

Semester	Year	Course
W S F
	_____	Equine Business Management (core course)
	_____	Management of the Equine Environment (core course)
	_____	Finance & Risk Management (core course)
	_____	The Equine Industry (core course)
	_____	Marketing & Communications (core course)
	_____	Equine Journalism (elective)
	_____	Stewardship of the Equine Environment (elective)

	_____	Equine Event Management (elective)
TUITION FEE - Early Bird $495.00 CDN per course
$549.00 CDN Regular Fee. (See course offering pages for Early Bird deadlines.) Course offerings vary with each semester. For current course offerings please contact the Office of Open Learning or visit www.EquineBusinessCertificate.com

BACKGROUND INFORMATION

Current Education Level:

Less than High School

High School

University or College

Please select the category which best describes you:

	Pleasure Rider			Farm, Ranch or Stable employee
	Breeder			Competitor
	Owner			Other_____________________

How many years in the industry?_____

How did you learn about the equine certificate? _________________________________________

PAYMENT INFORMATION:

Tuition costs: $ __________

Equine Guelph Donation: $ __________

OOL Bursary Donation: $ __________

Total Enclosed: $ __________

	Cheque/Money Order *(Payable to the University of Guelph)	Card #_____________________________
	Visa	Cardholder: ____________________________
	Master Card	Expiry: _____ /_____
	American Express	Signature: _____________________________

OOL Bursary:

Staff & friends of the Office of Open Learning (OOL) have established and contribute annually to a bursary fund to assist students in need. We invite you to consider making a contribution to this fund. If you wish, add your donation amount on the registration form. For further information visit: www.open.uoguelph.ca/bursary

Protecting Your Privacy:

We are committed to protecting your privacy. The personal information collected on this form will be used for registration purposes, for creating learner profiles, and for sending you relevant Open Learning information we believe may be of interest to you. For further information or to find out how to opt out of receiving future Open Learning information, call us at 519 767-5000 or visit: www.open.uoguelph.ca/privacy