Occasional & Part Time Studies Application Thank you for considering taking a course(s) at Redeemer University. Redeemer University aims to provide an education which is Christian and is shaped by the Christian faith as reflected in the Reformed tradition. Please complete this form and a staff member from the Registrar’s Office will contact you with more information. If you have any questions, please contact the Registrar’s Office at regoffice@redeemer.caPersonal InformationName* First Middle Last Former (Maiden) NameIf applicable, enter former name.Birth Date*Provide your birth date (mm/dd/yyyy). MM slash DD slash YYYY Address*Provide current mailing address. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Number*Provide your cell number.Email Address*Provide your email address, as communication will be directed to this account. Church InformationChurch Name*Provide the name of the church you are currently attending.Church Denomination/Affliation*Academic InformationAcademic Standing*Please check all applicable levels. Ontario Secondary School Diploma (OSSD) University or College degree Community College Other Specify OtherTranscriptsUpload college/university transcripts if you want to include them.Max. file size: 100 MB. Redeemer InformationHave you previously taken a course(s) at Redeemer University?* Yes No Indicate student ID number.If you remember your RU student id number, please provide it. Course #1 InformationAll courses taken at Redeemer University are in-person and on campus.Course Code #1*Provide the course name or course code that you wish to take. For example, BUS-121. Year/Term #1*Enter the year and the term that the course is offered. For example, 2017 fall term or 2017/FA.Course type #1*Do you want to take the course for credit or audit? Credit – expected to complete all course work; receive a grade Credit (Letter of Permission) – permission from another insitution to take the course; expected to complete all course work; receive a grade Audit – learning by listening; not expected to complete course work; receive an AU grade Letter of Permission Host InstitutionPlease provide the name of the host institution.LOP ApprovalUpload your LOP approval letter from your host institutionMax. file size: 100 MB. Do you want to take another course at Redeemer?* Yes No Course #2 InformationAll courses taken at Redeemer University are in-person and on campus.Course Code #2Provide the course name or course code that you wish to take. For example, BUS-121. Year/Term #2Enter the year and the term that the course is offered. For example, 2017 fall term or 2017/FA.Course type #2Do you want to take the course for credit or audit? Credit – expected to complete all course work; receive a grade Credit (Letter of Permission) – permission from another insitution to take the course; expected to complete all course work; receive a grade Audit – learning by listening; not expected to complete course work; receive an AU grade Letter of Permission Host InstitutionPlease provide the name of the host institution.LOP ApprovalUpload your LOP approval letter from your host institutionMax. file size: 100 MB. All courses are subject approval by the Redeemer’s Registrar’s Office.Additional InformationAny additional information that you would like to include with this application can be noted here.Statement of BeliefThe Redeemer University community acknowledges that the Bible is the Word of God. As God’s infallibly and authoritatively inspired revelation, the Bible makes known the way of salvation in Jesus Christ, requires a life of obedience to the Lord, and provides the key to understanding, interpreting, and finding purpose in life. The faculty and students at Redeemer University constitute a Christian community called to encourage one another to lives of faithful obedience to Jesus Christ. Applicants who do not share this Christian commitment or do not wish to participate in such a Christian community may not be in a position to appreciate Redeemer’s educational experience.Do you certify that you have read and understood Redeemer's Statement of Belief?* Yes No AcknowledgementI certify that the information on this application is truthful, complete and accurate. I understand that if any information in my application is determined to be false or misleading, concealed or withheld, my application may be invalidated and I have breached the University’s academic integrity policy, as found on page 38 of the Academic Calendar. I understand that this could result in rejection or revocation of an offer of admission or registration at the University. Do you certify the above Acknowledgement?* Yes No Application FeeApplication Cost Price: Credit Card* Total Name/Signature*By providing your name, you acknowledge that the above information is correct to the best of your knowledge. You also agree to follow the policies and regulations of the university as outlined in the Academic Calendar and Student Handbook. First Last