Please kindly complete the form below, filling in all applicable information and selecting the courses, then click "Continue" button to finish your On-Line enrollment process.
New Student
Re-enrolling Student
    Please enter your Student Number:
Personal Information:
Courtesy title:     MaleFemale
First Name: Middle Name:
Surname:
Birthdate:
Spouse's First Name:
Languages Spoken: Languages Written:
How did you learn about the Certified Credit Professional FCI Program?
Credit Institute of Canada Website Flyer in the mail
Colleague Supervisor/Manager
CA Magazine Ad CGA Magazine Ad
Enroute Magazine Ad Air Canada Magazine Ad
National Credit News Journal Ad Alumni College/University Magazine Ad
Local Newspaper Ad Bus Ad
Billboard Ad Career Counselor
Email/Mail from Local Chapter Industry Credit Meeting
Radio Career/Job fair
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Contact Information:
Home Address:
City or Town:
Province:     Postal Code:    
Home Phone:()-
Email Address:*
You will receive confirmation of your enrollment through email.
Please make sure your email address is correct.
Alternate Email:
Chapter
Employment Information:
Are you employed? (If you choose "No", the Employment Information would not be required.)
   Yes No
Position Title:
Industry:
Name of Employer:
Business Address:
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Province:Postal Code:
Business Phone:()- ext.
Business Fax:()-
Experience in credit profession(in years):
Income Range:
Responsibility Scope:
Receivable Responsibilities:
Shipping Information:
Shipping Address: (Please note: Books shipped require signature)
Please Ship my books to
Home Address Business Address
Previous Education:
Education Completed   
High School Name:Location:
YearMonthGrade 12 Diploma Completed? Yes No

List all post-secondary institutions previously attended
Name of
Institution
Location
City/Prov.
Year
Level
Attended
from
Yr/Mth
Attended
to
Yr/Mth
Name of
Degree/
Diploma
Designation
Received
Course Selection and Fees:
ProgramFees
Accounting Basics $325.00
Basic Law $325.00
Basic Credit Practices
        - A Guide for Today's Credit, Collection and Receivable Roles		 $325.00
Full Program $925.00

Payment Options:
Cheque/Money Order
Pay by credit card