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Student Information - Registration form for Ajax

How did you hear about us:

Surname:

First Name:

Preferred Last Name:

Preferred First Name:

Middle Name:

Date of Birth:

Gender - Prefer to Specify:

OEN:

Address:

City:

Postal Code:

Current Phone #:

Email Address:

If not born in Canada, date of entry (MM/dd/yyyy):

If you are not a Canadian Citizen, you must provide proof of Canadian Resident Status, Landed Immigrant Status or Student Visa Status.

First Language Spoken:

Emergency Information

Emergency Contact Name:

Emergency Contact Number:

Relationship to Emergency Contact:

Health Card #:

Previous Education

If yes, what year did you graduate:

Graduating School:

If you have not obtained your Ontario high school diploma, what was the name of the last high school you attended:

City of School:

Year:

I know the course(s) I need (please specify):

Is your schooling subsidized by Ontario Works or LEAP? If yes, please list contact person and their phone number:

Attach transcript or credit history if you have Ontario high school credits:

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Attach Photo ID:

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Attach citizenship document if born outside Canada:

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Attach Language Assessment if you took ESL/LINC classes:

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If you are experiencing trouble uploading your files, please send them by email to: cont.ed@dcdsb.ca Your registration will not be processed until all parts of the registration are complete.

Otherwise, skip to the bottom to review the Student Code of Conduct and press 'SUBMIT'.

Employment Training Programs

I understand that attendance and punctuality are mandatory for successful completion. Archbishop Anthony Meagher CCEC reserves the right to decline an application if a student is not able to meet the requirements.

Please review the Student Code of Conduct.

I acknowledge that I have read and understand these conditions:

YES

I acknowledge that my transcript will note: “Online Learning Graduation Requirement - Non-Applicable” as this is not a mandatory requirement for Adult Learners.

YES