Continuing Education - Course Registration

Your Information

* Name:

Mr. Mrs. Ms.    

Maiden Name:

(if applicable)

* Birth Date:

dd/mm/yyyy

Have you taken courses at Fleming before?   Yes   No

If Yes, Student #:

Contact Information

We will contact you regarding payment information. We accept Visa or Mastercard. In order to confirm your seat, payment must be received within 2 business days.

* When is the best time between Monday and Friday (7:30 am to 7:30pm) to contact you about payment?    

* Home Phone:

Alt. Phone:

* Email:

* Address:

* City:

* Province:

 AB    BC    MB    NB    NL    NT    NS    NU    ON    PE    QC    SK    YT  

* Postal Code:

Registration Information

Are you taking this course to fulfill the requirements of a college certificate or diploma?      Yes   No

If Yes, please specify:

Additional Information

How did you find out about this course?

What other Continuing Education courses would you like to see offered?

Got a question for us?