UBC Certificate in Peer Counselling

Application Form

Please complete this application form and submit it with any supporting documents. You many fax them to 604.822.3415 or mail to:

UBC Certificate in Peer Counselling
Life and Career Programs
1.400-800 Robson Street
Vancouver, BC Canada V6Z 3B7

* = required information

Personal Information

Name*
Address*
City*
Province*
Postal Code*
Telephone (day)*
Telephone (evening)
Fax
Email*
   
If you are an alumnus of UBC, please provide the following information:
Year of graduation:
Degree:
   
How did you hear about us?

Educational Background

List all degrees, diplomas, certificates and other formal or informal courses of study/qualifications that you consider relevant to your certificate application.

Degree/Diploma/Certificate/Course
Institution
Year Completed

Work/Volunteer Experience

Please give details of work or volunteer experience that you consider relevant to the program. You may include a resumé with those details if preferred, and submit it with your additional supporting documents to the email address, fax number or mailing address at the top of the page.

Nature of Activity
Company/Agency
Year(s)

Letter of Intent

Please comment on your expectations of this program and describe any specific learning goals you hope to achieve. Describe what attracted you to the program and how you see it helping you in your working/personal life. (approximately 300-500 words)

Personal information provided on the registration form is collected pursuant to section 26 of the Freedom of Information and Protection of Privacy Act (“FIPPA”), RSBC 1996, c.165, as amended. The information will be used for the purposes of: admission; registration; academic progress; notification of future courses; and operating other UBC-related programs. UBC collects, uses, retains and discloses information in accordance with FIPPA. UBC may share and disclose personal information within the University to carry out its mandate and operations. Information, in aggregate form only, may also be used for research purposes and statistics.

Should you have any questions about the collection of information, please contact Manager, Marketing Services, UBC Continuing Studies, 410-5950 University Boulevard, Vancouver, BC,
V6T 1Z3.

We Respect Your Privacy
Your contact information is maintained on our communications list and is used to send you the UBC Continuing Studies course calendar and other UBC communications regarding upcoming courses and events that may be of interest to you. Your contact information will not be released to others outside UBC.
Please check here if you do not wish to be on: mailing list (if this box is checked, you will not be mailed our course calendar)
email list



Once we have received your completed application and supporting documents, we will contact you regarding setting up an interview with the program manager.

If you have any questions, please call 604.822.0138.

 

a place of mind, The University of British Columbia

 

UBC CONTINUING STUDIES
Tel: 604.822.1444 | Email
Program Office Locations

Emergency Procedures | Accessibility | Contact UBC | © Copyright The University of British Columbia