Bridge to College Referral Form

To confirm your eligibility for OYAP, please contact your high school guidance counsellor or OYAP coordinator prior to submitting an application. Eligibility and application details will be reviewed by Niagara College and school board staff members.

Student Referral Information

Name(Required)

Legal First Name Legal Last Name

Gender(Required)

Male

Female

Undeclared

Date of Birth(Required)

Please note that students must be 16 years of age to participate in Bridge to College.

Address(Required)

Street Address Address Line 2 City Postal Code

Student's Phone Number(Required)

Student's Email Address (Personal)(Required)

Enter Email Confirm Email

Student Academic Information

Has the student applied to Niagara College or are they a previous Niagara College student?(Required)

Niagara College Student ID Number

Ontario Education Number (OEN)(Required)

School Board(Required)

High School (DSBN)(Required)

High School (NCDSB)(Required)

Halton Board High School(Required)

Hamilton Board High School(Required)

Other High School(Required)

Referring Partner Information

Referring Partner Name(Required)

First Name Last Name

Referring Partner Email Address(Required)

Enter Email Confirm Email

Referring Partner Position Title(Required)

Has this referral been discussed with the student?(Required)

Among the workplace level courses that this student is taking, is the student graduating with a minimum of 60% in Workplace English?(Required)

Consent to the Disclosure or Release of Information

By signing below, I acknowledge that I understand and give consent to Niagara College to collect, use and disclose my personal information for the purposes set out above.

Signature(Required)

Signature of parent/guardian is required as student is under 18 years of age. Please note that students must be 16 years of age to participate in Bridge to College.

Today's Date(Required)

This program requires basic computer literacy skills.

Niagara College Canada

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