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Online Application Form - Degree Program

Fill out the form provided in order to submit an online application for the Lansbridge University degree program.

Proper use of this form requires that you are running a recent version of a mainstream web browser like Internet Explorer and Javascript has been enabled. Lansbridge University conforms to the PIPEDA standard of data security.

To complete your application, you must also submit the following information by mail, email, or fax:

Name
Enter your full name the way you prefer it to be written *
Prefix
 Given name *
 Middle name(s)
 Family name *
 Suffix

Program Of Interest
Your intended start date *

Email
Your email address *

Telephone
Day time phone number *
Fax number

Mailing Information
Street *
City *
 State/Province *
Postal/Zip *
 Country *

Current Employment
Employer*

Job title*
Education*
Highest level of education completed *
 Degree/Diploma/Designation *
Previous education *
  Name of school City/Town Province/State Country
Trade school
College / University #1
College / University #2

Have you ever been required to withdraw from any post secondary institution? *
Yes
No 		If yes, name of institution
 Year occurred

Referrer
Where did you hear about Lansbridge University? *
Internet/Website
Social Media Group (Facebook, Twitter, LinkedIn, etc.)
Lansbridge alumni
Family/Friend
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Transfer Credits
Are you applying for credit transfer from another institution? *
Yes
No		 If yes, please consult the Admission Requirements for this program on
the website for credit transfer requirements and fees.

Summary
Provide a brief explanation stating why you are interested in applying to Lansbridge University *

Please review your form completely before you submit, and make sure all the fields are filled in correctly. You will NOT have a chance to change your form once it is submitted, except by contacting the admissions office directly.
To guard against automated form submissions, we require you to type the number shown in the image on the top into the box on below it.



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