Extended Learning

Non-Credit Course Registration Form

Have you ever applied to, attended or worked for Saint Mary's University?



If yes, please provide your "A" number ID:

Contact Information

Full Legal Name
Include your full legal name as it appears on your official identification documents, for example your birth certificate or passport. Your full legal name should also appear on all supporting documents.

First Name:
Middle Name:
Last Name:
Previous Surname:
Date of Birth:
Address:
Appartment:
City:
Province:
Postal Code:
E-mail:
Cell Phone (with area code):
Phone (with area code):
 

Citizenship Status

 



   
If you are not a Canadian citizen and you are residing in Canada, indicate your date of entry into Canada.
Date of Entry:
Country of Citizenship (If not Canada):
   
   

Program Selection

Please list your courses and dates:

Course Name: Date:
Course Name: Date:
Course Name: Date:
   
Course Fee(s): Total $

Payment Method

I will be paying in person by:






or over the phone by:

Please note: Registration is not complete until payment has been received. Classes fill up quickly and registration is on a first come first serve basis so please make your payment as soon as possible.

Registration will only be confirmed when payment has been received.

Please DO NOT send credit card information through the mail, by fax or email. Please make cheques payable to Saint Mary’s University.

If you have any questions or concerns please contact us at: 902-420-5492 or 902-420-5020.