CICE program application form

Home / Community Integration Through Co-operative Education program application steps / CICE program application form
Dark blue graphic circles on a white background.

  • MM slash DD slash YYYY

  • Loyalist College Program Area(s) of Interest:

    For example: Carpentry and Renovation Techniques/Technician, Child and Youth Care, Fitness and Health Promotion, etc. Please refer to our website to view all the programs offered at Loyalist College.

  • Post-Secondary School attended (if applicable):

  • Method of transportation:

    CICE Students must provide their own transportation to and from the College and field placements.

  • Technology Agreement

    Students will need a laptop for their studies, note: Chromebooks are not suitable as a personal computer due to incompatibility with Loyalist’s Learning Management Systems.

  • CICE RESUMÉ FORM

    Please fill in all three previous experiences if possible.

  • Experience #1

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Experience #2

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Experience #3

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • REQUIRED ATTACHMENTS

    Please attach the following documents in this application submission. All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith Personal Goals letter). Maximum upload size is 5MB and five (5) documents.

  • PERSONAL GOALS LETTER

    In a one-page typed or handwritten letter, explain your goals, how you (the applicant) think the CICE program will help you meet your goals, and why you need a modified program. This letter must be prepared by the applicant without assistance.
  • Accepted file types: pdf, jpeg, Max. file size: 25 MB.
    If you are able to upload your Personal Goals letter now, please proceed. *All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith Résumé). Maximum upload size is 2MB.
  • Accepted file types: pdf, jpeg, Max. file size: 25 MB.
    If you are able to upload your resume now, please proceed. *All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith Résumé). Maximum upload size is 2MB.
  • Accepted file types: pdf, jpeg, Max. file size: 25 MB.
    If you are able to upload your IEP document now, please proceed. *All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith IEP). Maximum upload size is 2MB.
  • Accepted file types: pdf, jpeg, Max. file size: 25 MB.
    If you are able to upload your high school transcript now, please proceed. *All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith Transcript). Maximum upload size is 2MB.
  • Accepted file types: pdf, jpg, Max. file size: 25 MB.
    If you have a Psycho-Educational Assessment and are able to upload it now, please proceed. if you receive an error please email in confidence to Rschock@loyalistcollege.com *All files must be in PDF or JPG form and saved as First Name, Last Name and Type of Document (e.g. John Smith Transcript). Maximum upload size is 2MB.

  • In accordance with Section 39(2) of the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c, F.31, this is to advise you that the personal information on this form is collected under the legal authority of the Ontario Colleges of Applied Arts and technology Act, 2002 and may be used and or disclosed for administrative, statistical and or research purposes of the College and or the ministries and agencies of the Government of Ontario and the Government of Canada, including but not limited to, tabulating and reporting data on Key Performance Indicators (graduate rate, graduate employment, graduate satisfaction and employer satisfaction). For more information, please contact fippa@loyalistcollege.com.
Save and Continue Later