NEW BRUNSWICK INFORMATION TECHNOLOGY COUNCIL

APPLICATION - CLASS OF 2011

APPLICANT INFORMATION

Last Name First M.I. Date

Street Address Apartment/Unit #

Postal
City Province
Code

Phone E-mail Address

What New Brunswick high-school are you

graduating from?

What University or Community College will

you be attending?

What is the Post-secondary institutions

name for the Program you expect to take.

REFERENCES
Please list three references who are not members of your family.

Full Name Relationship

Company Phone ( )

Address

Full Name Relationship

Company Phone ( )

Address

Full Name Relationship

Company Phone ( )

Address

OTHER INFORMATION

Please provide, or arrange to have provided, the following additional information:

1. A resume of past work and extracurricular activities
2. An official high-school transcript
3. A one to two page essay which explains why you have chosen this particular course of study, what you see yourself doing
5 years after graduation, and why you feel information and communications technology to be important to New
Brunswick. The essay should be, single-spaced and in 11 point Arial font.
SUBMISSION OF APPLICATIONS

Applications and all associated documentation must be received not later than May 31st, 2011, and can be sent to:
NBITC@NBITC.CA, or alternatively mailed to:

NBITC – Class of 2011,

46 Dineen Drive,
Fredericton, NB,
E3B 9W4

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to being selected for the Class of 2011, I understand that false or misleading information in my application or interview
may result in my being ineligible to participate in or complete the program.

Signature Date