Appendix A - Application Form

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Application Form for Review & Approval - Online Study Guide

Name of Course Provider:

Offical Name of Company and/or Organization as it is indicated in the registry of your province:

Name of Online Study Guide:

Course Provider Contact:

Address:

Phone:

Fax:

Email:

Web Address:

Web Address (Development site):

Language:

Instructions as per Section 5.0:

When completed, please return to:

Chief, National Pleasure Craft Operator Competency Program
Marine Security
Transport Canada
330 Sparks Street

Tower C, Place de Ville, 8th floor
Ottawa, Ontario
K1A 0N8

Note: The applicant shall provide copies of its Canada Business Corporation Act Incorporation Articles and Certificates or the equivalent documents issued under the law that created it.

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