Participant Application

Become a Participant

Learn How to Apply : HERE :

In order to be able to apply for courses on-line, you will have to fill out a Participant application form. Filling out this form does not mean that you are automatically enrolled at MIND. This is just another method of applying to the institution.

You will be provided with a username and password and it is important that you retain your username and password as you will need them to apply for future courses without having to re-enter this information. Once received and processed, you will be contacted by a representative of MIND.

If you have already applied and you simply want to login in, you may do so HERE

Participant Application

* Denotes a required field.

PLEASE SELECT THE PROGRAM YOU WOULD LIKE TO TAKE*

Title

Mr. Ms. Miss Mrs. Dr. Rev.

Name

Last Name*

First Name*

Middle Initial

Gender

Female Male

Birthday*

Home Address 1

Home Address 2

Home City

Parish

Home Country

Postal Code

Home Phone

Email Address*

Mailing Address 1
(While in school)

Only enter if different from Home Address

Mailing Address 2

City

Parish

Country

Person to be contacted in the event of an emergency

Name

Phone

Address 1

Address 2

City

Parish

Country

Please provide a summary of your formal education to date:
Institution	Final Year of Study	Level Attained or Certification Received






Notes:

Associate of Science Degrees and other prescribed programmes
Examining Body	Level	Subject	Grade	Date Awarded (mm/yyyy)








Notes:

Present Occupation

Name of Organization

Position

Address 1

Address 2

City

Country

Phone

Fax

Reason(s) for applying for this course/programme

Yes

Need Qualification for confirmation in post

Yes

Need Qualification for promotion

Yes

To improve work skills

Yes

For personal and professional development

Other

Heard about school from

Previously registered?

Yes No

Please list any health problems that may affect your program

Have you ever applied for a Student Loan?

Yes

Qualifications

Please Invoice

Or enter New: