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Online Application

  Part 1 - Personal Information
  Title Mr. Mrs. Other:
  Last Name
  Middle Initial(s)
  First Name
  Nationality
  Organization
  Job Title
  Employment Location
  Work Mailing Address
  Home Mailing Address
  Work Telephone
  Home Telephone
  Work Facsimile
  Home Facsimile
  Work E-mail
  Home E-mail
   
  Part 2 - Registration
  Please register me for the following course(s)
  Course Code / Name
  Dates
  Cost
  Deposit
  Enclosed
     
  Course Code / Name
  Dates
  Cost
  Deposit
  Enclosed
     
  Course Code / Name
  Dates
  Cost
  Deposit
  Enclosed
     
  Total
     
  Please select your preferred method of payment
  VISA
  MC
  AMEX
  Bank Transfer
     
  Note: Bank transfers should be made to the Pearson Peacekeeping Centre's account. Account #72-18, Bank of Nova Scotia, Annapolis Royal, Transit #60103





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