If applicants do not register in the semester to which they have been admied, their application becomes inactive. Reactivation of an application
is free if the reactivation request is made for the two semesters immediately following the semester for which the application was made.
Application for Reactivation
Legal first or given name:
Legal last or family name:
Langara ID Number:
City:
Province:
Circle Program Intake
PROGRAM INTENTION(S)
Jan May Sept
Jan May Sept
Legal middle name:
Former last or family name:
Date of Birth:
(YYYY/MM/DD)
Citizenship status:
Canadian Citizen
Permanent Resident
Other immigration status:
Study Permit
STUDENT CONTACT INFORMATION
Email address of applicant (Email is the primary form of communication from Langara):
Primary telephone:
Alternate telephone:
Permanent Mailing Address:
Country:
Postal Code:
COLLECTION, USE AND DISCLOSURE OF STUDENT INFORMATION
Langara College collects the information on this form under the authority of the College and Institute Act [RSBC 1996, Chapter 52, Section 41.1].
This information is needed, and will be used, for purposes that are consistent with activity necessary to the operation of the College and in
compliance with the provisions of the Freedom of Information and Protection of Privacy Act [RSBC 1996, Chapter 165]. This information will
be used for admission, registration, and maintenance of your student record. Information is shared with with Langara College Advancement,
Alumni Relations, Langara College Foundation, and the Langara Students’ Union.
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PERSONAL INFORMATION
DECLARATION OF APPLICANT
I certify and agree to the following:
• All statements on this application and supporting documents are true and complete.
• I authorize Langara College to verify any information provided as part of this application.
• I understand that evidence of falsified documents or misrepresentation will result in the cancellation of my admission or registration.
• I understand that information about falsified documents is shared with other Canadian colleges and universities.
• I understand and acknowledge that it is my responsibility to be aware of, and comply with, all Langara College policies and procedures.
• I understand that Langara College reserves the right to request original documentation/transcripts at any time.
• In consideration of Langara College permiing me to participate in any program, I hereby release Langara College, its officers, employees,
servants, agents, contractors, and subcontractors from any and all claims and waive any and all claims I may have now or in the future
against Langara College, its officers, employees, servants, agents, contractors, and subcontractors that arise out of or are related in any way
to my involvement in any program and all associated activities.
In addition to the above, all International Student applicants also certify and agree to the following:
• I understand that the Authorized Representative is permied to represent me up to and including my first day of LEAP or Regular Studies
classes only.
• I agree to purchase medical insurance if needed to cover my period of study.
Admission is subject to assessment of qualifications and availability of seats. Admission to the College does not guarantee the availability of
any individual course.
The personal information you provide on this form may be shared with the Ministry of Education and will be used to verify your British
Columbia Personal Education Number (PEN) or assign one to you. The personal information you provide and your PEN are used for
authorized statistical and research purposes only.
Some courses may require students to use electronic instructional resources where students log in by entering personal information, such as
name and email address, which is then stored on servers located outside Canada.
For questions about the collection, use and disclosure of your personal information, contact the Registrar at 604-323-5241.
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Student’s Signature
Date Signed (YYYY/MM/DD)
