"Newfoundland and Labrador Skills Development Employment Benefit Program Cost Form" - Newfoundland and Labrador, Canada

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Government of Newfoundland and Labrador
Department of Advanced Education, Skills and Labour
Newfoundland and Labrador Skills Development Employment Benefit
Program Cost Form
Applicant Information:
Last Name:
First Name:
Mailing Address:
Phone Number:
Email:
Program Information:
Program of Study:
Area of Specialization (if applicable):
The applicant will be registering in the
year of a
year program
st
nd
rd
1
, 2
, 3
, etc
1, 2, 3, etc
Total Length of Program (Weeks):
Level of Study (Certificate or Diploma):
Conditions of Acceptance (if applicable):
e.g., Certificate of Conduct, Medical Exam, Health Records, Grade Report Status, etc
Have these conditions been met? (Y/N):
Start
End
Scheduled Breaks
MM/DD/YYYY
MM/DD/YYYY
Christmas
Spring
Summer
Other (if applicable)
Costing Information:
Program Costs by Semester and Overall:
Other
Semester
Number
Tuition
Supply
Semester Start
Semester End
Book Costs
Compulsory
Number
of Weeks
Costs
Costs
MM/DD/YYYY
MM/DD/YYYY
Fees
N/A
N/A
Total
July 2017
1 of 2
Government of Newfoundland and Labrador
Department of Advanced Education, Skills and Labour
Newfoundland and Labrador Skills Development Employment Benefit
Program Cost Form
Applicant Information:
Last Name:
First Name:
Mailing Address:
Phone Number:
Email:
Program Information:
Program of Study:
Area of Specialization (if applicable):
The applicant will be registering in the
year of a
year program
st
nd
rd
1
, 2
, 3
, etc
1, 2, 3, etc
Total Length of Program (Weeks):
Level of Study (Certificate or Diploma):
Conditions of Acceptance (if applicable):
e.g., Certificate of Conduct, Medical Exam, Health Records, Grade Report Status, etc
Have these conditions been met? (Y/N):
Start
End
Scheduled Breaks
MM/DD/YYYY
MM/DD/YYYY
Christmas
Spring
Summer
Other (if applicable)
Costing Information:
Program Costs by Semester and Overall:
Other
Semester
Number
Tuition
Supply
Semester Start
Semester End
Book Costs
Compulsory
Number
of Weeks
Costs
Costs
MM/DD/YYYY
MM/DD/YYYY
Fees
N/A
N/A
Total
July 2017
1 of 2
Government of Newfoundland and Labrador
Department of Advanced Education, Skills and Labour
Work Term (Y/N):
Paid/Non-Paid (if yes, specify weekly wage):
Work Term Start (MM/DD/YYYY):
Work Term End (MM/DD/YYYY):
Institution and Official Information:
Institution Name:
Campus (if applicable):
Mailing Address:
Official’s Name (print):
Official’s Title (print):
Telephone:
Fax:
Email:
Completion of this form indicates that this individual has been accepted into the program as
described above.
Signature:
Date:
General Information
The purpose of the Program Cost Form is to provide the necessary program and cost information to
process a Newfoundland and Labrador Skills Development Benefit application. This form must be
completed by an official of the educational institution. Completion of this form constitutes confirmation of
acceptance into the program of study and verification of costs associated with the program.
Please ensure all sections of this form are completed.
Do not put the generic start and end dates of the semester on this cost form if they do not
apply to the student for whom this form is being completed. The dates given should be
specific to the student whose name appears on this form. For example, if the program/semester
normally starts in September, but the student does not start until November, then this form should
have a start date of November.
Indicate the full name and mailing address of the educational institution. Official institutional
stamps are accepted. The Program Cost Form should be signed and dated by an authorized
official, providing a telephone number, fax number, e-mail address, and the printed name of the
authorized official.
Link to Departmental Employment Offices (Fax # provided):
http://www.aesl.gov.nl.ca/career/employment_centres.pdf
July 2017
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