CMU CMU Application Form
CMU CMU Application Form
CMU CMU Application Form
Section 1: How to Complete the Application Procedure (To be completed by Shaftesbury Campus and Outtatown Applicants)
The following must be received in the Admission office in order for your application to CMU Shaftesbury Campus
or CMU’s Outtatown Discipleship School to be considered complete:
o Completed application form, specifically sections 1,2, 3, 4, 5, 6, 7 for Shaftesbury Campus or Sections 1, 2, 3, 4, 5, 9 for Outtatown.
o Application fee (non-refundable $80 for Canadian/US students with Canadian/US transcripts; $150 for International students).
This fee is waived for Canadian and US students if the application process is completed by November 30 (including official transcripts).
Applications and/or transcripts post-marked after November 30 require a $80 non-refundable fee.
o Official high school transcripts (interim if still in school, final as soon as possible). Photocopies, faxes, and emails are not acceptable.
o If still in high school, a listing from your school of current courses you are/will be taking in your senior year (grade 12).
o Official post secondary transcripts if applicable. Photocopies, faxes, and emails are not acceptable.
o If applicable a copy of Marriage or Name Change certificate.
o Two reference forms (required for all Outtatown applicants and Shaftesbury Campus students planning to live on campus).
o Completed housing portion form (section 8) if living on campus.
Payment Method:
o Cash (in person only) o Interac o Money Order (payable to CMU) o Cheque (payable to CMU)
o VISA o Master Card Card Number ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____
500 Shaftesbury Blvd., Winnipeg, MB, R3P 2N2 Canada | T: 204.487.3300 | TF: 877.231.4570 | Fax: 204.487.3858 | [email protected] | www.cmu.ca
If not Canadian, please check one: o Permanent Resident* o Refugee o Planning to apply for a Study Permit
If English is not your primary language, indicate the number of years of English instruction you have received: ________________________
If you are of Aboriginal ancestry, please specify: o First Nations (status) o First Nations (non-status) o Inuit o Metis o Other
(By declaring your status, you will help in the development of new services and events for Aboriginal students. The declaration is voluntary.)
Denomination: ______________________________________________________________________________________________________
Friends or relatives who currently attend or have attended CMU/Outtatown, or predecessor colleges (CMBC, MBBC, Concord):
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Section 3: Previous and Current Education (To be completed by Shaftesbury Campus and Outtatown Applicants)
List in chronological order all* of the high schools** (since grade 11) attended (name, location, dates attended, graduation date).
Name of Institution Location Dates Attended Grad Date
_________________________________________ _________________________________ ___________________ ___________
Accomadations may address physical limitations, learning disabilities, allergies, or mental health issues you have. Declaration
is always voluntary. CMU strives to provide a fair and supportive learning environment for academically qualified students with
disabilities. Disabilities include both mental and physical conditions which meet the following criteria: The condition is permanent,
ongoing, episodic, or of some persistence, and the condition causes a significant limit for the person in carrying out some of life’s
major activities.
_____________________________________________________________ _______________________________________________________________
Signature Date
Section 8: Housing Information (To be completed by Shaftesbury Campus Applicants)
Name:___________________________________________
I plan to make the following living arrangements for the school year:
o Live off campus (be a communter student) o Live on campus (be a resident student) (please complete this section)
Applications for housing should be submitted as early as possible, preferably by February 28. Applying early will increase your chance of
receiving the accommodation you want. All housing assignments are made by a CMU housing committee using the following guidelines:
Housing Request
If you have previous experience in residential living, please give details (e.g. where, how long?) and give reasons for your housing selection
(to assist the housing committee in assigning space): _______________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Did you indicate any allergies, physical limitations, learning disabilities or mental health issues in section 4? o Yes o No
Please indentify any allergies, disabilities, difficulties, or other special needs of which CMU should be aware of that could affect your accom-
modation needs:
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
If you have a spouse and/or children who will be living with you, please indicate name of spouse and name(s) and age(s) of children.
Spouse: __________________________________________________________
Before submitting this form please read the statement about CMU values and student responsibilities in Section 1 of the Application Form.
The CMU Student Handbook, which you will receive at registration, provides further details regarding CMU community life policies. These
include restrictions on use of illegal drugs, alcohol, tobacco, pornography, and non-marital sexual activity. By signing this application form,
you are committing yourself to living in accordance with CMU community life standards. (If you want more information, contact the Student
Life Department at CMU.)
Please return this form by February 28 in order to receive priority consideration. A non-refundable deposit of $100 will be required in
spring to reserve your housing assignment.
Reference forms help us to get to know you and serve you better. They are required if you plan to live on campus.
Please give a reference form to two people (e.g. teacher, person in your church or community, family friend), not family members, and ask
them to complete the form and fax or mail it directly to CMU. List the names and phone numbers of your two references here. (Note
that reference forms for CMU Shaftesbury Campus and Outtatown are different.)
Comments: _________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Comments: _________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
References
Reference forms help us to get to know you and serve you better. They are only required if you are applying to CMU’s Outtatown
Discipleship School.
Please give a reference form to two people (e.g. teacher, person in your church or community, family friend), not family members, and ask
them to complete the form and fax or mail it directly to CMU. List the names and phone numbers of your two references here. (Note
that reference forms for CMU Shaftesbury Campus and Outtatown are different.)
Additional Information (This information is required due to the nature of a travelling community, international legal issues
and the work we do with children and youth ministries.)
Have you ever been suspended or expelled from a secondary or post secondary school? o Yes o No
Have you ever been convicted of a misdemeanor or felony? o Yes o No
If the answer is yes, please attach an explanation of circumstances and dates of incident(s).
Did you indicate any allergies, physical limitations, learning disabilities, or mental health issues in Section 4? o Yes o No
Please indentify any allergies, disabilities, difficulties, or other special needs of which CMU should be aware of that could affect your accom-
modation needs:____________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
o I consent to have the following individual(s) discuss my application and financial account with appropriate CMU staff. (e.g. parents)
o I confirm that the above statements and supplied information are true.
Signature ____________________________________________