Request Information Please complete the form below and Stenberg College will contact you with more information: Program of Interest: Cardiology Technologist Community Support & Outreach Worker Early Childhood Educator Hospital Support Specialist Medical Laboratory Assistant Medical Office Assistant Nursing Unit Clerk Practical Nursing Psychiatric Nursing Health Care Assistant (formerly Resident Care Attendant) Special Education Assistant Contact Name --- Dr. Mr. Mrs. Ms. First Last E-mail Address City State/Prov. Zip/Postal Code Country Home Phone Cell Phone When is the best time to reach you? Morning Afternoon Evening Grad Year 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 When would you like to start school? ASAP 3 Months 3 - 6 Months 6 Months - 1 Year 1 Year or More How did you hear about us? where did you hear about us 24 hours The Province Community Newspaper(s) Employment Paper Georgia Straight Employment & Labour Market Services (ELMS) Family/Friend Former/Current Student Google Facebook learning.vancouversun.com Buses/skytrain Professional Association Yellow Pages Walked/Drove by Other Other: Address Suite 750 - 13450 102nd Avenue Surrey, BC V3T 5X3 Telephone 604-580-2772 Toll Free 1-866-580-2772 Fax 604-580-2774