Aboriginal Education and ACCESS Programs
F210 – 2055 Notre Dame Avenue,
Winnipeg, Manitoba R3H 0J9
COMMUNITY DEVELOPMENT /
COMMUNITY ECONOMIC DEVELOPMENT
SUPPLEMENTAL
APPLICATION
This supplementary application form is for support of full-time studies at Red River College
All complete applications are screened to ensure that applicants meet program criteria. Applicants who
meet all program criteria on paper will be subsequently invited for an interview. All candidates will be
notified whether or not they successfully qualified. Those who passed admissions requirements and
assessments will be sent a letter with the start date of the program, details about orientation, and the
class schedule for the first term.
If you have any questions, please contact Lisa Robinson at (204) 632-2499, toll-free (855) 413-7854, FAX:
(204) 633-1437 or e-mail [email protected] . We wish you success in furthering your education and look
forward to receiving your application.
APPLICATION CHECKLIST
All questions are to be answered fully in applicant’s own handwriting. This information is confidential
and will be used to assess your eligibility and suitability for the program.
ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED.
A complete application must include:
□ A.
Official transcript of your complete academic record from high school and, if
applicable, any college, technical institute, or university you have attended. Postsecondary transcripts must be submitted directly from the post-secondary institution.
High school transcripts may be submitted by the applicant, but must be originals printed
on school letterhead, signed by a school official, and sealed with the school seal.
If you would like to keep your original documentation, please submit the original and a
copy. The copy will be verified and the original will be returned to you.
□
B.
Red River College application and application fee ($95.00 cheque or money order made
payable to Red River College for the registration fee).
Return this completed application to:
Red River College
COMMUNITY DEVELOPMENT / CED Program
F210 – 2055 Notre Dame Avenue, Winnipeg, Manitoba R3H 0J9
Ph: 204-632-2180
or 1-855-413-7854 FAX: 204-633-1437
Have you applied to the Community Development/ CED program before?
If so, what year? __________
□ Yes
□ No
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A. PERSONAL HISTORY
NAME __________________________________________________________________________
(Please print)
Last
First
Date of Birth _____/ _____/ _______
Day
Month
Initial
Age ______
Year
Present Address
_____________________________________________________________________________________
City: _______________________________Province: _________________Postal Code____________
Home Community / Permanent Address (if different from above)
_____________________________________________________________________________________
ANCESTRY: Because this program is housed in the School of Indigenous Education and we build a
community with strong relationships amongst ourselves, we would like to know a little about you so
we can make you feel at home.
If Aboriginal, please tell us about your status and home community:
First Nation/ Location___________________________________________________________________
Which applies?
□ First Nation
□ Metis
□ Inuit
If non-aboriginal, what is your mother tongue (the one your first spoke)? _________________________
What other languages do you speak? ______________________________________________________
If you are an immigrant, how long have you lived in Canada? ___________________________________
If you are an immigrant, in what country were you born? ______________________________________
If you were born in Canada, what communities have you lived in? _______________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
B. PAYING FOR YOUR EDUCATION
We understand the struggle students have to manage living arrangements & family life, attend full-time
studies, and provide for financial stability. Please tell us what arrangements you have made to support
yourself during your two year diploma program. Check whichever applies.
□ Funding/ Grant from Outside Source □ First Nation □ Manitoba Metis Federation
□ Employment Insurance
□ Workers Compensation
□ Employment Income Assistance
□ Other ___________________________________________
□ Part-time work
□ Savings
□ Family / Spouse
□ Student Loan
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C. PREVIOUS EDUCATION
Please tell us about all the learning experiences you have had to date (formal education, on-the-job
training, workshops, and other relevant life experiences).
What is your highest level of formal education?
YEAR: ___________
□ High School (incomplete)
□ High School upgrading
□ High School Graduate
□ College Certificate □ College Diploma
□ Undergraduate Degree
□ Masters Degree
Upgrading – Have you received upgrading since you left high school?
□ Yes
□ No
Name of institution & location _______________________________________________
Highest Grade Level Achieved _______________________________________________
If you attended post-secondary education, please tell us what programs you were enrolled in.
College:
Name of College __________________________________________________________
Program(s) ______________________________________________________________
________________________________________________________________________
________________________________________________________________________
University:
Name of University ________________________________________________________
Program(s) ______________________________________________________________
________________________________________________________________________
________________________________________________________________________
Other Learning: Please tell us about any other formal or informal learning you have engaged in. This can
be workshops you attended, on-the-job training, or your gifts, talents & strengths. Think of what skills
you have and how you got them.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you ever been suspended or placed on probation from any post-secondary institution? □Yes
□ No
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D. EMPLOYMENT / COMMUNITY INVOLVEMENT
***PLEASE ATTACH YOUR MOST CURRENT RESUME
CHECK THE BOX THAT MOST CLOSELY DESCRIBES YOUR CURRENT SITUATION.
□ Employed Full-Time (30+ hours per week)
□ Casual
□ Student
□ Employed Part-Time
□ Employed Seasonally
□ Volunteer
□ Unemployed
□ Stay at home parent/ homemaker/ caregiver
VOLUNTEER/ COMMUNITY INVOLVEMENT
List all volunteer experiences and community work which you have engaged in, including what your job
title/ responsibilities were.
Organization
Job/Function
Year
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
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E. KNOWLEDGE & EXPERIENCE RELEVANT TO COMMUNITY DEVELOPMENT
Please describe in detail experiences you have had related to the field of Community Development/
Community Economic Development (CD/CED).
___________________________________________________________________________________ __
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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What personal qualities do you feel that you possess which would help you to work effectively in
CD/CED?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please describe your career goals.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Please describe your communication and problem-solving skills with diverse groups of people.
________________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Why do you want to take this program?
______________________________________________________________________________
______________________________________________________________________________
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______________________________________________________________________________
______________________________________________________________________________
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Tell us anything else you wish that will help us to know you better and guide us in our decision making.
______________________________________________________________________________
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Please describe any clubs, projects, hobbies, etc. in which you are currently involved.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
F. DECLARATION



To the best of my knowledge, I certify that the information contained in this application is
true and correct.
I realize that any false statement contained in this application may result in my
disqualification from this program.
As a result, I hereby authorize the disclosure to Red River College and Community
Development/ Community Economic Development Program any pertinent information from
relevant parties that may be required to substantiate information herein declared.
Name (print) __________________________________________________________________________
Signature ____________________________________________________ Date ____________________
FOR OFFICE USE ONLY
Term: _______________
Applicant Accepted:
o Yes
Schedule Interview:
o Yes
Recommend Upgrading:
o Yes
o No
o No
o No
Date: _____________
Course: _________________
Chair/Program Coordinator Signature:
Date:
____________________________________
__________________________
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