Online Application

1. Student Information


2. Contact Information


3. Parent Information


4. Program Information


5. Parent Consent Form


At Coquitlam College we feel that extra-curricular activities are an important part of the College's programs and that all students benefit greatly by participating in them.

Check the box beside any activity you do NOT want your son/daughter to participate in:

Badminton
Baseball
Basketball
Camping
Field Trips
Floor Hockey
Golf
Hiking
Horseback Riding
Ice Skating
Skiing
Snowboarding
Snowshoeing
Volleyball
Whale Watching
Water Sports
Please Note:
It is mandatory that all students have valid medical insurance.

6. Complete & Submit Application


* Required

By clicking Submit Application, I declare that the information in this application is complete and correct.