Application for

Admission
Cape Breton University Tel: 1-888-959-9995 or (902) 563-1166
Student Service Centre/Admissions Office Fax: (902) 563-1371
P.O. Box 5300, 1250 Grand Lake Road, E-mail: admissions@cbu.ca
Sydney, Nova Scotia B1P 6L2 Apply online at www.cbu.ca/admissions

Previous CBU Student ID #

*Term Applied For:  Fall (Sept 20__)  Winter (Jan 20__)  Spring (May 20__)  Other_________

Please Print
1.  Mr.  Ms. __________________________________________________________________________________________________
 Mrs.  Miss First Name Middle Name Last Name

Preferred first name:_________________________ Previous surname (if applicable)______________________________

*2. Permanent Home Address

Street Address, Apartment Number, Box Number

City Or Town County Province Country Postal Code

Home Telephone Cell/business phone: Email Address

Effective Until ____/____/____
3. Mailing Address (for correspondence)  same as above, or
Year Month Day
Street Address, Apartment Number, Box Number

City Or Town County Province Country Postal Code

4. Marital Status:  Single  Married  Other 4b. Sex:  Male  Female

5. Social Insurance Number: ________ - ________ - ________ *6. Date of birth: ______/______/______
Year Month Day
*7. Country of Citizenship: ___________ Date of Entry into Canada ______________ Immigration Status
(copy of Landing Document required)  Landed Immigrant
 Visa
7b. Optional Self-Identification
An aboriginal person is a North American Indian or a member of a First Nation, Métis, or Inuit. North American
Indians or members of a First Nation include status, treaty, or registed Indians, as well as non-status and
non-status registered Indians.
• Are you an Aboriginal person? yes  no  If yes, please specify  North American Indian/First Nation
 Métis  Inuit
• Are you a member of another visible minority? yes  no  If yes, specify______________________________
Aug 2010

*8. Mother Tongue:  English  French  Mi’kmaq  Other ______________________________________

9. Do you have a permanent disability?  Yes  No
If yes:  Mobility  Hearing  Vision  Learning  Mental Health  Other_______________________
* indicates mandatory fields
*10. Program Applied For (check one ONLY):

POST DEGREE PROGRAMS continued...

 MBA (CED) – please use MBA application form available
UNDERGRADUATE DEGREE PROGRAMS
at www.cbu.ca/admissions
Bachelor of Engineering Technology (BET)
 Bachelor of Education Electronics and Controls  3-year program
Note: application requires additional material. See www.cbu.ca/  1-year post-diploma
admissions for details. Deadline is January 10 for application and Environmental Studies  3-year program
all supporting documentation.  1-year post-diploma
Manufacturing  1-year post-diploma
Education Programs (Post Degree) (available only by Distance)
 Diploma in Education (Curriculum) Petroleum  3-year program
 Diploma in Education (Counseling)  1-year post-diploma
 Diploma in Educational Technology
 Certificate in Educational Studies (Arts Education) Bachelor of Technology (BTech)
Emergency Management 

UNDERGRADUATE DEGREE PROGRAMS Degree Transfer Programs
 Bachelor of Science - Human Nutrition (2 yr. Transfer)
 Bachelor of Engineering (BEng) (2 yr. Transfer)
 Bachelor of Arts (BA)  Bachelor of Computer Science (1 yr. Transfer)
(intended concentration/major if known)  Bachelor of Science - Human Kinetics (1 yr. Transfer)
______________________________________________  Bachelor of Arts - Human Kinetics (1 yr. Transfer)

 Bachelor of Arts Community Studies (BACS)
(intended academic field/major if known) Access Programs

___________________________________________  Elmitek (access for Aboriginal students)
___  Mi’kmaq Science Advantage
 Bachelor of Business Administration (BBA)
(intended concentration /major)


__
____________________________________________ DIPLOMA & CERTIFICATE PROGRAMS
 Bachelor of Arts Community Studies/Bachelor
Diploma Programs
of Business Administration (BACS/BBA)  Public Administration and Management
___________________________________________  Diploma in Engineering Technology (Instrumentation & Controls)
___  Diploma in Engineering Technology (Petroleum)
 Bachelor of Science (BSc)
(intended concentration/major if known) Certificate Programs
 Canadian Institute of Management
______________________________________________
 Heritage Studies
 Bachelor of Science Community Studies  Ethnomusicology
 Professional Development
(BScCS) (intended concentration if known)
 Public Administration
 Social Research
____________________________________________  Theatre Arts
__
 Bachelor of Science Nursing (BScN)
Note: Deadline is February 28 for application and all OTHER
supporting documentation.  No Specific Program
 Visiting Student (Please have your home institution
 Bachelor of Health Sciences (Public Health) supply a letter of permission)
(BHSc)  Other (please specify) _____________________________
 4-year program
 2-year post-diploma/degree

 1-year in-career

 Bachelor of Hospitality-Tourism Management
(BHTM)

 *11. PREVIOUS EDUCATION INFORMATION
Name City/Town Province Country Year Attended
High School

College or University 1

College or University 2

College or University 3

*Highest Grade Completed: Grade 11  Grade 12  OAC  OTHER  *Is Your School Semestered? Yes  No 

*Currently are you attending (check one) High School  University  College  No Educational Institution 

*Are you applying as a non-traditional student? Yes  No  If yes last year of school attended:_______________
A non-traditional student is a person who: Highest grade completed:______________________
• has completed at least Grade 10
• has been out of high school for two years
• is at least 20 years old

*12. Have you previously studied at:  CBU or UCCB  College of Cape Breton  Xavier Junior College
 N.S. Eastern Institute of Technology? If so, what year(s)? ____________________

13. How did you hear about Cape Breton University?.__________________________________________________________

Agent number if applicable________________________________________

*14. If you are applying for distance education, please check here 

NOTE: If you plan to seek transfer credits or prior learning assessment credits, you must fill out the ap-
propriate form and pay the application fee. Forms are available at the Student Service Centre and on the
Cape Breton University Website at www.cbu.ca/admissions.

CBU does not guarantee that applications completed after August 1 will be processed for September
registration.

I agree to abide by the regulations of Cape Breton University. I certify that the information provided is correct. I understand that if
I enrol in a co-operative program, I consent to the release of my academic record to prospective employers.

__________________________________________ ___________________________________________
Signature Date

Application Processing Fee - $35 (CDN Funds), International Students Fee - $100 (CDN Funds)
______________________________________________________________________________________________________
Please Print Name

Cheque or Money Order payable to Cape Breton University OR Charge to VISA  or MASTERCARD 

Number_____________________________ Expiry Date __________ Signature of Cardholder ____________________________

Aug 2010

Canadian students must submit an application fee that is not refundable: for MBA - $80.00, for Education Programs - $50.00, and for all other programs - $35.00. The International Student fee is
$100.00. Make cheque or money order payable to Cape Breton University. If you plan to seek residence accommodation, you must submit a residence application.
 RESIDENCE APPLICATION
Mail To: Residence Office
Cape Breton University
MacDonald Residence
P.O. Box 1991, 1250 Grand Lake Road
Sydney, Nova Scotia, Canada B1P 6Z5

Please Note: Your application must be accompanied by a $25.00 application fee. Students who are offered accom-
modation in Residence are required to pay a $250.00 confirmation deposit, which will be applied to the fees of the
first semester. Failure to pay the confirmation fee will result in cancellation of the room assignment. This $250.00
confirmation deposit is our guarantee of your firm intention to live in Residence for the entire academic year, and
once paid it is non-refundable unless you do not receive acceptance to Cape Breton University. This application
is for residence accommodations for the full academic year beginning at registration and ending on the day after
your final examination in April, but excluding the Christmas recess. Refunds of Residence fees are not granted for
any student withdrawing from the Residence at any time during the academic year, except in those circumstances
set forth in Cape Breton University’s Academic Calendar. Students in Co-operative Education programs beyond
the first year may be given accommodation for one term.

Former CBU ID# :______________ Sex:  Male  Female Birth Date: ____/____/____
Year Month Day

Name: ___________________________________________________________________________________
Family Name First Name (underline name usually used) Middle Name

Permanent Mailing Address (please give complete details): E-mail: _______________________________

Street/Apt #: ______________________________________________________________________________

City/Town: _____________________________ Province/State: _______ Country: _______________________

Postal Code: _____________ Telephone home: ( )________________ Work: ( )__________________

E-mail Address: _________________________________ Fax: ( )____________________

Summer Mailing Address (if different from Permanent Mailing Address, from May 1- August 31):

Street/Apt #: ______________________________________________________________________________

City/Town: _____________________________ Province/State: _______ Country: _______________________

Postal Code: _____________ Telephone home: ( )________________ Work: ( )__________________

Program Applied for at Cape Breton University: ___________________________________________________

(eg. Arts, Science, Business, etc.) Year of Program (eg. 1st, 2nd)

Please indicate the term you are applying for: Sept. – Apr.  Sept. – Dec.  Jan. – Apr.  May – Aug.

Are you aware of any mental or physical condition(s) of which the Deans or Residence Office should be advised?

RESIDENCE Fee - $25 (CDN Funds)

Please Print Name
Cheque or Money Order payable to Cape Breton University OR Charge to VISA  or MASTERCARD 

Number Expiry Date

Signature of Cardholder
Do you require consideration for room access or services due to physical disability or impairment? If
yes, what is the nature of your disability?

 Mobility  Hearing  Visual  Other ___________________

Do you have any allergies that would require special assignment or consideration? (List)

_______________________________________________________________________________________

Are you on a medically prescribed diet? Arrangements can be made through our food services. (The University
reserves the right not to enter into a Residence Arrangement if the situation is too complicated).

_______________________________________________________________________________________

Which style of residence are you applying for?:  Dorm  Apartment  Either

1st Choice: _____________________________________________________________________________

Is there someone you know who will be living in Residence and with whom you would like to share a room?
We will make every effort to match applicants with their choice of roommates.

1st Choice: ______________________________________________________________________________

2nd Choice: ______________________________________________________________________________

3rd Choice: ______________________________________________________________________________

Do you have his/her approval?:  Yes  No

Would you prefer your roommate to be:  1st year  2nd year  3rd year  4th year  N/A

Would you prefer that your roommate be in the same program?:  Yes  No  N/A

Please Note: ALL Residences are NON-SMOKING!

It is understood that Cape Breton University has the right to make regulations under which students may be permit-
ted to remain in Residence and the student in making application agrees to abide by such rules and regulations.

 I agree to allow my contact information to be given to potential roommates.

Date: _________________ Signature: ______________________________________

For more information, contact: Doug Connors

(902) 563-1791 For Office Use Only:
doug_connors@cbu.ca
Application Fee:
Date:
Receipt #:

Confirmation Fee:
Date:
Receipt #:
Aug 2010
 Entrance Scholarships/
Bursaries/Awards
Information

Each year Cape Breton University awards a number of Entrance Scholarships to high
school students.

• All new students entering directly from high school who apply by March 1st are automatically
considered for entrance scholarships.

• Bursaries are awarded on the basis of financial need. Other criteria may also be used in
awarding bursaries.

• As some scholarships and bursaries have special requirements, they must be applied for
separately from the application for admission. Applications for these scholarships can be
found at www.cbu.ca/scholarships.

Please send entrance scholarships and bursaries applications to:

The Office of the Vice-President Student Services and Registrar

Cape Breton University
P.O. Box 5300, 1250 Grand Lake Road
Sydney, Nova Scotia
Canada B1P 6L2
E-mail: awards@cbu.ca

For additional information please refer to www.cbu.ca/scholarships

Admissions Application Checklist
All of the following boxes should be checked before submitting your admission application:
 Form is completed and signed.

 Non-refundable application fee is enclosed ($35.00 Domestic/$100.00 Foreign Student).

 Transcript of High School grades (Ask your guidance counselor to send an official copy to
the Admissions Office).

 If transferring from another institution, get official transcripts sent from transfer institution
(University or College).

 Official copy of proof of English Language Proficiency Testing Score (if first language is not
English or previous education was not delivered in English)