HomeMy WebLinkAboutOCDSB 100 ESL Exit Form-Elem
English as a Second Language Exit Form - Elementary
Student's
Name:
School Name:
Grade: Age: : ____________________
Date of Enrollment in ESL Program
m/d/y
___________________________ is exiting the ESL program, effective ____________________
(name of student) m/d/y
(e.g., strengths exhibited by the learner, areas for further support,
Additional comments
accommodations to consider, etc.)
ESL Teacher ______________________
Homeroom Teacher _______________________
Principal ________________________
Notice of Collection:
The personal information on this form is gathered under the authority of the Education Act (R.S.O. 1990 c.E.2)
ss. 58.5, 265 and 266 as amended, as well as Immunization of School Pupils Act and the Personal Health Information Protection Act, and will be
used by the school and central administrative staff to register and place the student, and to provide a broad range of academic, health and
administrative services. In addition, the information may be used to deal with matters of health and safety or discipline and may be disclosed
as required by law under the Education Act or any other Act. Anyone having the right may access this information by contacting the principal
of the school. For questions about this collection, speak to the school principal. Specific questions can be directed to Freedom of Information
Coordinator at OCDSB-Administration Building, 133 Greenbank Road, Ottawa, ON, (613) 596-8211.
Original – OSR
Copy – Parents/Guardians
- - PR.614.CUR
OCDSB 100 (CUR) (01/12)
- - PR.614.CUR