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TDLI RE-ADMISSION FORM

PLEASE READ: A student must submit a TDLI RE-ADMISSION FORM to learner services if the student has been academically suspended or has not enrolled at TDLI for one full semester term (10 weeks). We require all students to fulfill their requirements sequentially, therefore, must take all courses in the sequence they are listed in. A $100.00 CDN rate charge is required for re-admission, and must accompany this form, via money order, or Visa, or Master Card called into 1 888 686 6163, with your full details to Student Services. Please submit your form for processing and allow up to 4 weeks for your process to be processed by student services, you will be notified by registered e-mail, registered letter, and-or telephone to arrange your enrolment in the next semester.

1. Student Name: ___________________________________

2. Student ID: _______________________________________

3. Course Name and Course Number:


4. Date: ________________ E-mail: ____________________

5. Enrolment Semester: ______________________________

6. Requested Re-Enrolment Semester Date: ___________________________________________________

7. For Credit Card Payments Please Print your information here:

Credit Card Type: ___________________________________
Credit Card Number: _________________________________
Exact Name on CC: __________________________________

Three or Four Digit Pin On Back of Card: ________________
Signature: __________________________________________
Date: ______________________________________________

You may also phone in your Credit Card Information to us!!
1 403 347 9019, 1 888 686 6163, or 1 403 454 2887.

8. If you have not been enrolled or continuing your studies at TDLI Please indicate the reasons below:

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Students Signature and Date:


Student Services Officer Signature: ___________________________________________________

Presidents Signature and Date: ___________________________________________________

END OF TDLI RE-ADMISSION FORM.