Pre-registration is required for all courses.

Payment is due at time of registration unless there is a pre-approved P.O. or letter of authorization attached.

Please indicate the program for which you are registering.

  • National Advanced Certificate in Local Authority Administration Level I
  • National Advanced Certificate in Local Authority Administration Level II

Please note:

If you withdraw two weeks before the course starts, a 20% penalty will be charged. A 50% penalty will be charged if you withdraw within two weeks of the course start date.

There is no refund after the course begins.

The cost of textbooks and/or course packs is notincluded in the Course Fee. You are required to purchase these separately from the Dalhousie Bookstore at or a prior student (ensure you have the most recent edition).

For Office Use Only

Registration Date:______

Alex#______

ILO#______

Invoice/Receipt #: ______

National Advanced Certificate in Local Authority Administration

Registration Form(please print clearly)

Address: ⃝ Home ⃝ Work (invoicing purposes)

Last Name______First Name______Middle Initial______

Job Title______Organization______

Home or Work Address______

City______Prov.______P.C .______

Phone Home ( )______Work ( )______Cell ( )______

Email Address______

(please print clearly)

*Fall 2013
Sept 16 – Dec 6, 2013 / *Winter 2014
Jan 13 – Apr 4, 2014 / *Spring 2014
Apr 14 – Jun 27, 2014
  • Local Government
  • Human Resource Management
  • Local Government Accounting
  • Public Administration Professionalism
/
  • Municipal Law I
  • Freedom of Information Privacy Foundations
  • Organizational Behaviour and Leadership
  • Financial Management
/
  • Property Taxation and Assessment
  • Organizational Design and Management
  • Local Government Finance
  • Municipal Law II

*registrations are limited to 25 per course and are accepted on a first come first served basis. You are strongly urged to register prior to August 31, 2013 for all 2013/2014 courses.

Payment Information

Please make cheque payable to College of Continuing Education. Registrations cannot be processed without full payment (P.O. #, credit card, cheque). If an employer is to be invoiced, a letter of authorization must accompany this registration form, otherwise registration will not be complete. You will receive confirmation of your registration from Dalhousie University by email.

Admission Fee(all new students pay a one-time, non-refundable fee) $95 $ ______

Course Fee($895 per course) $ ______

Total Course Fees$______

Method of Payment

  • Enclosed is a cheque payable to College of Continuing Education
  • Please bill my employer. A copy of my pre-approved P.O. or letter of authorization is attached.
  • Please charge Credit Card ⃝Personal or ⃝ Organization

⃝VISA ⃝ MC ⃝ AMEX Card Number:

______/ ______/ ______/______Expiry: _____/_____

Signature: ______

College of Continuing Education | Registration Form – Local Government Certificate Programs / 1

All Students

By submitting this form and signing below you are indicating that you have read, understood and agree to abide by the procedures and policies contained in the Program Regulations Handbook. The handbook can be found at Proceed to: Continuing Management Education; Local Government.

Signature:______Date: ______

APPLICATION FOR PROGRAM ADMISSION (new students only)

Education
Institution / Degree/Diploma/Certificate/
Professional Designation / Year completed or highest level obtained
Work Experience
Employer / Position / Years of Service

You may wish to submit, under separate cover, additional information to support your application.

How did you hear about the local government certificate programs?

⃝ Brochure ⃝ Calendar ⃝Professional Association⃝ Seminar/Workshop ⃝ Word of Mouth ⃝ Conferences

⃝Other ______

Submit this completed form with

a cheque/P.O. number/Credit Card/

Letter of Authorization to:

College of Continuing Education | Registration Form – Local Government Certificate Programs / 1