Student Application Form – Cross Over Community Development

Apply for COCD Career Bridges Program

If you are interested in COCD’s Career Bridge program, please complete the form below and someone will be in touch with you shortly to advise on next steps.

Student Application

Please complete the form below. Fields will be submitted securely to COCD.

First Name

Last Name

Date of Birth

Gender Preference

Street/Address

City

State/Province

Zip

Country

Emergency Contact

Emergency Contact Name

Relationship to You

Emergency Contact Phone

This emergency contact phone is a mobile number

Additional Information

If employed, where?

Do you need daycare?

Citizenship Status

Do you have Wi-Fi at home?

Acknowledgements

I understand that I will take assessments for placement into the appropriate level based on my current abilities. I have read COCD’s Core Values. I have read and agree to abide by COCD’s Code of Conduct. I have read and understand COCD’s Safeguarding Policy, Protocol and Resolution. I agree to support COCD’s Program Guidelines and Policies.

Thank you for applying.