School Registration Form

HWDSB-CCE SCHOOL REGISTRATION FORM

Community and Continuing Education Program Red Hill ADS  King William ADS  FASTtrack  Advantage  Next Steps  D2L Hybrid  PoW  W4C 

PART A: STUDENT INFORMATION Legal Last Name: Legal First Name: Middle Name D.O.B. MM/DD/YYYY

Telephone (Home) Student Number (ESIS or PowerSchool) Enrollment Start Date Male 

Female  Residence Status Country of Citizenship Country of Birth Date of Entry to Canada (YYYY/MM)

Province of Birth Ontario Entry Date (MM/DD/YYYY) First Language Spoken Language at Home

Street Address Apt # City/Town Postal Code

email address (HWDSB students must use HWDSB account) OEN #: - - Last School Attended OSSD  OSSD (pre 1999)  SSGD 

Community Hours Completed  OLC Completed  Previous Credits Earned: ______Community Hours Incomplete  OLC Incomplete  Not Required  Not Required  Diploma Date: ______(MM/DD/YYYY) Participant in OW (Worker’s Name) Participant in other program (Worker’s Name)

Office: ______Office: ______Eligible for Grade 9/10 PLAR  yes Eligible for Grade 11/12 PLAR  yes Maturity Credits Granted: Referred to AC: ______ no  no (MM/DD/YYYY) ______Completed: ______Completed: ______Completed: ______MM/DD/YYYY MM/DD/YYYY MM/DD/YYYY EMERGENCY CONTACT Last Name First Name Relationship

Home Phone Cell Phone Medical Conditions

Epi Pen  Life Threatening  PART B: COURSE SELECTION RED HILL ADS/KING WILLIAM ADS AM 9:00 – 11:45: Section # PM 12:15 - 3:00 Section # ______D2L Hybrid Program Course 1 Section # Course 2 Section # ______

GOALS: Work for Credit Session 1 Session 2 Session 3 Session 4 Session 5 08-SEP-2015 to 29-OCT-2015 to 4-JAN-2016 to 29-FEB-2016 to 3-MAY-2016 to REGISTER DATES 28-OCT-2015 18-DEC-2015 26-FEB-2016 2-MAY-2016 27-JUN-2016 1 Cr. Co-op AM 11 21 31 41 51 (P1) 2 Cr. Co-op AM 12 22 32 42 52 (P1)/ PM (P2) Course: Start Date: End Date: Final Mark: ILC/eL Course 1 - incl. start date (P2) I1

Course: Start Date: End Date: Final Mark: ILC/eL Course 2 - incl. start date (P2) I1

Course: Start Date: End Date: Final Mark: ILC/eL Course 3 - incl. start date (P2) I1

FASTtrack and Next Steps Session 1 Session 2 Session 3 Session 4 Session 5 REGISTER 08-SEP-2015 to 29-OCT-2015 to 4-JAN-2016 to 29-FEB-2016 to 3-MAY-2016 to DATES 28-OCT-2015 18-DEC-2015 26-FEB-2016 2-MAY-2016 27-JUN-2016 Next Steps AM

C (P1) 71 73 75 77 79 C O R U E

R KW FASTtrack D S

I AM (P1) 91 93 95 97 99 E T S KW FASTtrack class 2 AM (P1) 01 03 05 07 09 R C Next Steps (P2) 72 74 76 78 70 E O M U E R KW FASTtrack D S

I PM (P2) 92 94 96 98 90 E A S L KW FASTtrack class 2 PM (P2) 02 04 06 08 00

ILC/eL Course 1 - incl. start date (P2) I1 Course: Start Date: End Date: Final Mark: I L

C ILC/eL Course 2 - incl. start date (P2) I1 Course: Start Date: End Date: Final Mark:

ILC/eL Course 3 - incl. start date (P2) I1 Course: Start Date: End Date: Final Mark:

Advantage Session 1 Session 2 Session 3 Session 4 Session 5 08-SEP-2015 to 29-OCT-2015 to 4-JAN-2016 to 29-FEB-2016 to 3-MAY-2016 to REGISTER DATES 28-OCT-2015 18-DEC-2015 26-FEB-2016 2-MAY-2016 27-JUN-2016

P1 - inclass 61 63 65 67 69

P2 – inclass or Co-op 62 64 66 68 60 (1cr. Only)

ILC/eL Course 1 - incl. Course: Start Date: End Date: Final Mark: I1 start date (P2)

PoW Course information W2 Course: Start Date: End Date: Final Mark: