Online Application for Admission Form

Please complete the form below to submit your Coquitlam College Application for Admission. Please note that your application will not be complete until payment has been successfully received.

Program Information

* required

Please select a program.
Please select a semester.
Please indicate whether you have an agent.

By choosing this Agent, you authorize Coquitlam College to speak directly with this Agent on your behalf.

Please select the agent.
Please enter a valid email.

Who is eligible to claim commissions?

Only authorized Coquitlam College agents who have valid agent agreements with Coquitlam College are eligible to claim commissions. If your agency name is not on the drop-down list, a commission payment will not be calculated for this student. Please contact agents@coquitlamcollege.com for further assistance.

Student Information

* required

Please enter your last name.
Please enter your first name.

Sex *

Please select an option
Please enter your citizenship.
Please enter your place of birth.
Please enter a valid birthdate (yyyy-mm-dd).

Require Homestay *

Please select an option

Do you have a valid study permit? *

Please select an option

Are you a permanent resident or Canadian citizen? *

Please select an option

School Information

Contact Information

* required

Please enter your address.
Please enter your city.
Please enter your province.
Please select your country.
Please enter your postal code.
Please enter your email.
Please enter your phone number.

Parent Information

Parent Consent

Check the box beside any activity you do NOT want your son/daughter to participate in:

Submit Files

* required


Please supply all of the following, if available.
study permit / pr card / passport *

File formats: pdf, jpg, png     File size limit: 4MB

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Please upload your study permit.

transcripts *

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Please upload your transcript(s).

additional files

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Review your Information


program information

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student information

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First Name: {{ index.applicationForm.first_name }}
Sex: {{ index.applicationForm.sex }}
Citizenship: {{ index.applicationForm._citizenship_country.name }}
Place of Birth: {{ index.applicationForm._place_of_birth_country.name }}
Birthdate: {{ index.applicationForm.birth_date }}
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Do you have a valid study permit?: {{ index.applicationForm.have_student_visa }}
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school information
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contact information

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parent information
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Uploaded Files

study permit / pr card / passport
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Transcripts
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Additional files
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