Health Care Aide Program

APPLICATION

Tansi,

Thank you for your interest in the Health Care Aide Program at University nuhelot’įne thaiyots’į nistameyimâkanak Blue Quills. This 8 month certificate program provides you with the knowledge necessary to complete the provincial health care aide examination and earn a Health Care Aide license. The curriculum encompasses both Indigenous wisdom and western theory.

THE APPLICATION PROCESS

The application process is detailed and will require the commitment of a significant amount of your personal time and effort. The completion of each of the components of this admission package is integral to ensuring that your application will be processed in an effective manner.

Applicants are encouraged to submit the following documents by the funding deadlines set by their sponsor, although later submission can still be considered for admission.

Blue Quills Application Form (attached)

Official High School Transcripts;

Official Post-Secondary Transcripts, if applicable;

Accuplacer Testing (if necessary contact the Librarian to schedule an appointment)

Personal Written Statement (Your interest in the program)

Current Resume

Two letters of Recommendation

Criminal Record Check

Immunization Record

PROGRAM APPLICATION CHECKLIST

I have:

Ordered my official high school transcripts from Alberta Education	_____

(Order forms may be obtained from the Registrar’s office or on-line at:

https://education.alberta.ca/transcripts/how-to-order/

There is a $10 fee to process transcripts.

Applicants are responsible for requesting transcripts and fee payment)

Ordered my official post-secondary education transcripts from all

post-secondary institutions that I have attended	_____

Completed Accuplacer Testing	_____

(Appointment for Testing if necessary - contact the Librarian)

Attached a completed copy of my Personal Written Statement.	_____

Current Resume	_____

Two letters of Recommendation/references,	_____

And,

Personal interview completed with Team Lead.	_____

(Date and name of faculty __________________________ _____)

Provided an Immunization record _____

Provided a Criminal Record Check _____

If you have any questions about the application procedure, please contact the Registrar at (780) 645-4455 or 1-888-645-4455 or mail to: donnaw@bluequills.ca

Registrar’s Office

University nuhelot’įne thaiyots’į nistameyimâkanak Blue Quills

Box 279, St. Paul, AB. T0A 3A0

APPLICATION PACKAGE

Personal Written Statement

Please answer the following questions in paragraph format:

(double spaced word-processed responses are preferred)

Please describe your interest for pursuing a career in the Health Care Aide program.

Please describe your reasons for wishing to complete your health care aide certificate within a program that possesses an Indigenous cultural foundation.

Please identify and describe those skills and experiences that you believe indicate your personal suitability to the field of a Health Care Aide worker.

Leading a healthy lifestyle is an essential requirement. Please describe your plans

for ensuring that the following elements of your life will be addressed in a

healthy manner throughout the duration of your studies.

Potential life challenges

Family and community commitments

Spiritual needs

Academic responsibilities

Financial considerations

Certificate in Health Care Aide Program

Application Package – Confirmation of Reference Requests

I have provided the following two individuals with a copy of the Reference Form and they have agreed to send the completed form to the attention of the Registrar at University nuhelot’įne thaiyots’į nistameyimâkanak Blue Quills by mail or fax.

Reference #1:	_______________________________________

Organization	_______________________________________

Position	_______________________________________

Telephone	_______________________________________

Reference # 2:	_______________________________________

Organization	_______________________________________

Position	_______________________________________

Telephone	_______________________________________

Mail:	Registrar

University nuhelot’įne thaiyots’į nistameyimâkanak Blue Quills

Box 279, St. Paul, AB T0A 3A0

phone: 645-4455 or 1-888-645-4455

fax:	780-645-4730

SPECIFY PROGRAM YOU ARE APPLYING FOR: ___________________________________ Program Start Date: Fall  Year: ______Winter  Year: _______Spring  Year: _______Full-time Part-time Have you previously applied to or, attended University n Blue Quills? □ No □ Yes Program: ______________________________________ Year____________________

APPLICATION FOR ADMISSION

PERSONAL INFORMATION Name_________________________________________________ Previous Surname (if Applicable):________________________________ First Middle Last Gender: Male □ Female □ Other □ Date of Birth: ________/________/_________ SIN________-________-_________
month day year Address___________________________________________ City ___________________________ Prov. _________ Postal Code ______-______ Telephone ________________________ (Cell) ________________________ E-mail Address _________________________________________ Contact Person in case of Emergency: _____________________________________ Contact’s Phone #:______________________________ Status:  Treaty  Non-Status  Metis  Other Band Name _______________________________ Treaty/Metis # _____________________

DECLARATION The information I have provided is true and complete in all aspects. I understand that the personal information collected on this form will be maintained as part of a student record and will be used for the purpose of admission, registration, and for operating the programs and activities of the University. I further understand that the University will ensure the protection of personal information against such risks as unauthorized access, collection, use, disclosure or destruction.	Signature:_________________________________________________________________________ Date:________________________________________________________ Box 279, St. Paul, AB T0A-3A0 Toll Free 1-888- 645-4455 or (780) 645-4455 * Main Fax: (780) 645-5215 Registrar’s Fax: 780-645-4730 E-mail: registrar@bluequills.ca Visit us at: www.bluequills.ca FEE ASSESSMENT (Non-refundable) Application Fee $100.00 Date Paid _____________ Cash  Certified Cheque Money Order  E-transfer  Credit Card  FINANCIAL ASSISTANCE MY TUITION WILL BE PAID BY:  SELF  SPONSOR Sponsor’s Name: ______________________________________________ Address: ____________________________ City: ___________________ Prov: _________ Postal Code ________-________ Phone: _______________________ Fax: __________________________ Contact Person: _______________________________ Ext: ____________ NOTE: Certified Cheque or Money Order should be made payable to“University nuhelot’įne thaiyots’į nistameyimâkanak Blue Quills (For Office Use Only) BQ ID #: Receipt #: Cheque #:	FORMAL EDUCATION HISTORY	Name of High School (list most recent first)	Province/State/Country	Grade Completed	From mm/yyyy	To mm/yyyy
Name of Post-Secondary Institution	Province/State/ Country	From mm/yyyy	To mm/yyyy	Diploma/Degree/Credential Earned	Date Conferred