Fillable SUMMER REGISTRATION - CREDIT COURSES Grand Erie Learning

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SUMMER REGISTRATION - CREDIT COURSES Grand Erie Learning

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Country of origin: CANADA
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SUMMER REGISTRATION - CREDIT COURSES
Grand Erie Learning Alternatives
(519) 753-6079 www.granderie.ca
Deadline: June 25, 2021 – email to: summerregistration@granderie.ca
Legal Last Name
Legal First Name
Usual Name
☐ Male ☐ Female ☐ Other
OEN
Present School Name and School Board Name
Student Email (used in school)
Parent Email
Date of Birth (MM/DD/YYYY)
Address (No. & Street, City/Town, Province, Postal Code)
Current Grade
Home Phone
Parent/Guardian #1 Name & Phone
Emergency Contact Name
Canadian Citizen?
☐
Yes
☐
No
(If no, please submit immigration documents)
First Nations Status?
☐ Yes ☐ No
New Credit or Six Nations
Resident?
☐ Yes ☐ No
First Choice Course
Note: *LIMIT OF 1 CREDIT TO BE EARNED* If registering for both Civics and Careers (.5 credit each), please place
both courses in First Choice section. If you have an IEP, please ask your school to scan it to the email above.
Secondary students must consult their counsellor to ensure proper course code and pathway has been selected.
Parent/Guardian signature (for all students under age 18 years):
Signatures: Counsellor (secondary) or Principal (elementary)
Student Signature:
July 6, 2021 to July 30, 2021
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SUMMER REGISTRATION - CREDIT COURSES Grand Erie Learning

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Completed 25 June 2021

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