HomeMy WebLinkAboutApplication for Admission to Secondary SchoolOCDSB 966 - Application for Admission to Secondary School
School Name
Legal Surname: Legal First Name: Legal Middle Name:
Preferred Surname: Pref erred First Name: Pref erred Middle Name:
Present Grade:
Present Program: List of Siblings in the School Board:
Has the student ever attended an OCDSB School? Yes No
Previous School:
Previous School Board:
Previous Program:
Has the student successfully completed a Gr. 10 Literacy test? Yes No
Health Card Number: Version:
Medical Alert Information/Disability/Allergies:
Does the student have a life-threatening medical condition:
Please explain condition:
Country of Birth: Province of Birth:
Country of Citizenship: Immigration Status in Canada:
Languages Spoken at Home:
Main Language at Home: First Language:
Home Address
Street Name: Street Number: Apartment:
City: Province: Postal Code:
Home Phone: Unlisted Listed
Special Educati on
Has the student ever received special education assistance? Yes No
If “Yes” to above, provide dates and locations:
Does the student have an IEP? Yes No
Voluntary Indigenous Self-Identification
Is the student of Indigenous descent or ancestry?
If “Yes”, please select: First Nation
ESL/ELD Program
Yes
Inuit
No
Metis
Has the student been in an ESL program in the past?
If so, wh en
Yes No
FRC USE ONLY
Recommended STEP Placement 1-6
ESL Oral Reading W riting No ESL
Oral Reading W riting
SECONDARY Registration Form – Admissions & Enrolment (June 20 19)
OCDSB 966 To be filed in OSR
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Gender: Male___ Female___ Prefer
not to Disclose___ Self Identified:______Student’s Date of Birth:
Parent/Guardian Information
Surname: First Name: Relationship:
Immigration Status in Canada: Place of Employment:
Emergency Contact Priority: 1 2 3 School Closure Contact Priority: 1 2 3
E-mail (1): E-mail (2):
Cell: Home Phone: Business Phone:
Guardian: Custody: Lives with Student:
Agency Name (if applicable): Access to Records: Receives Mail:
Address (Street Number): Street Name: Unit/Apartment:
City/Township: Province: Postal Code:
Surname: First Name: Relationship:
Immigration Status in Canada: Place of Employment:
Emergency Contact Priority: 1 2 3 School Closure Contact Priority: 1 2 3
E-mail (1): E-mail (2):
Cell: Home Phone: Business Phone:
Guardian: Custody: Lives with Student:
Agency Name (if applicable): Access to Records: Receives Mail:
Address (Street Number): Street Name: Unit/Apartment:
City/Township: Province: Postal Code:
Emergency Contact Information (Other Than Parents/Guardians)
Surname: First Name:
Relationship to Student: Place of Employment:
Emergency Contact Priority: 1 2 3 School Closure Priority: 1 2 3
Home Phone: Business Phone:
E-mail (1): E-mail (2):
Parent / Guardian Signature Da te
Proof of Residency – check two: current agreement of purchase of sale or rental lease
current utility bill current property bill current phone/cable/internet Other:
Proof of Age (what was seen?):
Acknow ledgement
The personal information on this form is collected under the authority of the Education Act (RSO. 1 990 c.E.2) and in accordance with the M unicipal
Freedom of Information and Protection of Privacy Act (RSO. 1 990 c.M56), as amended. It will be used to establish the Ontario Student Record [OSR] and
for s tudent and education related purposes such as registration, a dministration, communication, collection of fees, d ata reporting, and Student
Transportation Services. In addition the information may be used or disclosed to comply with legislation, for compelling circumstances affecting health and
safety or discipline, as r equired in circumstances related to a llow enforcement matters, and with third parties in accordance with the established service
agreements or in accordance with any other Act. Questions or concerns should be directed to the school principal or the Board’s Freedom of Information
Coordinator, Ottawa-Carleton District School Board, 133 Greenbank Road, Ottawa, Ontario, K2H 6L3, Telephone 613-596-8211.
SECONDARY Registration Form – Admissions & Enrolment (June 2019)
OCDSB 966
To be filed in OSR
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