Screening Application for February 2007

“Strengthening Canadian Fitness…One Pro at a Time!”

SCREENING APPLICATION FOR September 2012/ Jan 2013

Can Fit Pro certification courses/ Credit Bundle

Please complete PARTS A & B OF THE SCREENING APPLICATION FORM thoroughly and RETURN TO YOUR HOME SCHOOL GUIDANCE OFFICE. Please print clearly.

PART C separate form must be completed by three referring teachers (all teachers must be your current teacher).

Application Information:

Currently in Grade: 10 11 12 13 Gender: M { } F { }

First Name: ______Last Name: ______

Birth Date: ______Age: ______

Address: Street: ______

City: ______Postal Code: ______

Phone: #1 (905) ______Phone: #2 (905) ______

Email: ______

1) If the courses were filled would you like to be put on a waiting list to be accepted for Semester 2 academic year? Y N

2) If you were accepted into the program would you be enrolled in just these three credits?

3) Who referred you to this program?

______

If no individual referred you, where did you find information about this program?

______

PART A

Please answer the following questions:

1. How have you been involved in physical activity, or assisting others with physical activity? Please explain.

______

2. Please rank your top 4 areas of interest: (1 –highest and 4- lowest)

Sports Nutrition Fitness Instructor Theory

Physiology & Anatomy Communication Skills

Personal Training Theory Leadership

Fitness Testing Culinary Skills

3. Describe your reliability using examples such as school attendance, job performance, extra curricular activities etc.

______

Other:______

4. We will be working with individuals in the community that have mental and physical disabilities. What qualities, strengths, and skills can you bring to these unique hands on experience?

______

5) Are you considering a career path in the fitness industry (Personal Training or Fitness Instructing)? Y N

7.a) Are you considering an academic path in kinesiology or Health related fields (college or university? Y N

6) Maturity, professionalism and a positive attitude are necessary components to be a part of the Can Fit pro program, please describe how you have demonstrated these skills in the past or present

______

· Please note that we are in the process of creating two semesters for Can Fit Pro please check off your first choice. Please indicate below that if you are not placed in your first choice if you would like to be a candidate for the second choice program.

o Semester 1 Can Fit Pro University/ College Program

* Option to add period 1 exercise science

Period 2- HFA4M (Grade 12 university/ college nutrition course) with Nutrition and Wellness Certification

Period 3 IDC4U/ IDC40 (grade 12 university/college interdisciplinary course) and Personal Trainer certification

Period 4- Lunch

Period 5- PLF4C (Grade 12 leadership course) and Fitness Instructor Certification

o Semester 2 Can Fit Pro College Program

Period 2- IDC40 (Grade 12 Open Interdisciplinary Credit) Personal training certification with the potential to also earn a Nutrition Wellness Certificate

Period 3- PLF4C (Grade 12 leadership course) and Fitness Instructor Certification

Period 4 & 5 (2 credit Co-op)- The co-op will be in a fitness placement where students will learn hands on/ applicable techniques in order to enhance their resume upon completion of their certification.

o If I am not accepted into my first choice, I would like to be considered for the second choice.

* Please not this is a competitive program and both programs are highly competitive

PART B

PARENTAL APPROVAL:

I understand that my son/daughter is applying for the Can Fit Pro Certification PROGRAM at Aldershot for semester one, September 2011. I am also aware that there is a small program cost for a part time gym membership and a textbook, transportation and additional field trips. My son/daughter has my permission to apply for this course. Notification of acceptance into the program to follow. Thank you very much for your time and consideration of this new program.

· If you are applying for this program outside of Aldershot or Halton, you must also complete a student registration form and hand it in with your application

______(905) ______

Parent/Guardian Signature Date Parent /Guardian Contact

Note to Parents and students applying

· Please note that the application component of this program is very competitive and the acceptance is based on four components 1) the application form 2) The three reference letters from current teachers that will be sent to Can Fit Pro head office 3) The interview that is also reviewed by Can Fit Pro head office and 4) Ensuring that all instructions are followed out as described in a timely manner.

· In order for students to have the best chance it is imperative that they have all parts of the form completed and submitted in a timely manner and that they have 3 current teachers act as part of their reference letter (the teacher is to put that letter in the courier to myself C. Greenslade at Aldershot High School, or email it myself ).

PART C

PLEASE PASS PART C ALONG TO 3 REFERRING TEACHERS

* All three references MUST be from CURRENT teachers

* Your teacher is to then put this reference letter in the courier to my attention* Cara Greenslade

Reference Section of Application Form: a supporting teacher must fill out this section.

· Note to the teacher

· I appreciate you taking the time to take the application process seriously.

· Please answer the following to the best of your ability. Students who are accepted in this program will have the opportunity to become certified personal trainers, fitness instructors and nutrition specialists. The students will also have the opportunity to work with people in the community including the elderly, individuals with mental and physical disabilities so it is imperative that the candidates selected for this course can monitor themselves and be respectful in these rare learning opportunities. I need to make sure I am giving opportunities to students who are able to conduct themselves in an appropriate manner and make sure that they have the potential to become certified at the end of the semester.

· This is only to be completed by three current teachers. These teachers will be contacted for feedback at the end of the semester to see if the evaluation remains the same.

Students Name ______

Please complete this section to the best of your knowledge, please rate the applicant using the following criteria: 1 (low) to 5 (high)

Team Work 1 2 3 4 5

Verbal Communication skills 1 2 3 4 5

Demonstrates initiative 1 2 3 4 5

Maturity 1 2 3 4 5

Takes Responsibility 1 2 3 4 5

Positive Rapport with staff and

Students 1 2 3 4 5

Professionalism 1 2 3 4 5

Interpersonal Skills 1 2 3 4 5

Respect for others 1 2 3 4 5

Reference comments: (It is particularly important to mention how they will act in the community, especially when dealing with students/adults with mental and physical disabilities, the elderly and varying socioeconomic backgrounds)

______

· The student will not have access to your confidential survey

· This survey is imperative to make sure the right candidates are selected for the program and to ensure that we are upholding Can Fit’s standards in addition to the ministry.

Printed Name of Referring Teacher: ______

Signed:______Date: ______

PLEASE PASS PART C ALONG TO 3 REFERRING TEACHERS

* All three references MUST be from CURRENT teachers

* Your teacher is to then put this reference letter in the courier to my attention* Cara Greenslade

Reference Section of Application Form: a supporting teacher must fill out this section.

· Note to the teacher

· I appreciate you taking the time to take the application process seriously.

· This is only to be completed by three current teachers. These teachers will be contacted for feedback at the end of the semester to see if the evaluation remains the same.

Students Name ______

Please complete this section to the best of your knowledge, please rate the applicant using the following criteria: 1 (low) to 5 (high)

Team Work 1 2 3 4 5

Verbal Communication skills 1 2 3 4 5

Demonstrates initiative 1 2 3 4 5

Maturity 1 2 3 4 5

Takes Responsibility 1 2 3 4 5

Positive Rapport with staff and

Students 1 2 3 4 5

Professionalism 1 2 3 4 5

Interpersonal Skills 1 2 3 4 5

Respect for others 1 2 3 4 5

______

· The student will not have access to your confidential survey

· This survey is imperative to make sure the right candidates are selected for the program and to ensure that we are upholding Can Fit’s standards in addition to the ministry.

Printed Name of Referring Teacher: ______

Signed:______Date: ______

PLEASE PASS PART C ALONG TO 3 REFERRING TEACHERS

* All three references MUST be from CURRENT teachers

* Your teacher is to then put this reference letter in the courier to my attention* Cara Greenslade

Reference Section of Application Form: a supporting teacher must fill out this section.

· Note to the teacher

· I appreciate you taking the time to take the application process seriously.

· This is only to be completed by three current teachers. These teachers will be contacted for feedback at the end of the semester to see if the evaluation remains the same.

Students Name ______

Please complete this section to the best of your knowledge, please rate the applicant using the following criteria: 1 (low) to 5 (high)

Team Work 1 2 3 4 5

Verbal Communication skills 1 2 3 4 5

Demonstrates initiative 1 2 3 4 5

Maturity 1 2 3 4 5

Takes Responsibility 1 2 3 4 5

Positive Rapport with staff and

Students 1 2 3 4 5

Professionalism 1 2 3 4 5

Interpersonal Skills 1 2 3 4 5

Respect for others 1 2 3 4 5

______

· The student will not have access to your confidential survey

· This survey is imperative to make sure the right candidates are selected for the program and to ensure that we are upholding Can Fit’s standards in addition to the ministry.

Printed Name of Referring Teacher: ______

Signed:______Date: ______