Form

BORDER CROSSING COURSE
APPLICATION FORM:

Please complete all fields on this form. Incomplete application forms cannot be processed. When you apply for one of our courses on-line, payment must accompany your application. Please provide your credit card information below. Application forms without payment willnot be processed.

Border Crossing Course

Cost $150.00 (CDN Funds)
Course tuition is tax exempt

Course Date:

Fill In Date Given By Office Here:
To Take the Course in: London Sarnia Windsor (select one)

First Name
Last Name
Your Phone Number: (include area code)
Address:
City:
Province:	, Canada
Postal Code:
Driver's Licence #:
Class of Licence:

Payment Information:

Method of Payment:

Cardholder's Name:

Card Number:

Expiry Date: (M/Y)

Payment Amount
to be appplied to card:

Signature: (Enter your email address here)

When you enter your email address in the "Signature" field on this form, it will act as your electronic signature for this application.

You can also 427 Exeter Rd., London ON N6E 2Z3 along with your payment.

Back

Submitting this form does not guarantee entry to this course.
Confirmation of enrolment will be sent to you by email once your application has been processed by the office.

Method of Payment:
Cardholder's Name:
Card Number:
Expiry Date: (M/Y)
Payment Amount to be appplied to card:

BORDER CROSSING COURSE APPLICATION FORM:

Please complete all fields on this form. Incomplete application forms cannot be processed. When you apply for one of our courses on-line, payment must accompany your application. Please provide your credit card information below. Application forms without payment willnot be processed.

When you enter your email address in the "Signature" field on this form, it will act as your electronic signature for this application. You can also 427 Exeter Rd., London ON N6E 2Z3 along with your payment.

BORDER CROSSING COURSE
APPLICATION FORM:

When you enter your email address in the "Signature" field on this form, it will act as your electronic signature for this application.

You can also 427 Exeter Rd., London ON N6E 2Z3 along with your payment.