Registration

Name*

Gender*

Female

Male

Date of Birth*

OEN Number or Student Trillium Number

Present Grade*

Current/Most Recent Secondary School Location*

Email (Please add your email, not the email of your guardian)*

Course(s) you are applying for*

Address*

Guardian/Parent Phone Number*

Alternate Phone

Health Card Number

Do you have a medical condition?*

Yes

No

If "yes" please give additional information

Do you require an Epi-Pen?*

Yes

No

Emergency Contact Name*

Emergency Contact Phone Number *

CONDITIONS OF ACCEPTANCE

I will follow the school Code of Behaviour, be respectful to all of the staff, attend classes regularly and on time, understand that the previous school(s) may be contacted. NO MONEY BACK AFTER TWO WEEKS.

*

I agree

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