Current school you are attending and School Board Address Number City Street Province Apt # Postal Code Home Telephone Number Date of Birth ( ) - Student Contact email address (required must check regularly) – Parent/Guardian Contact Information (please print) 1. Parent/Guardian Last Name Given Name Telephone address (required must check regularly) – Bus. ( ) - Cell ( ) - 2. Parent/Guardian Last Name Given Name Telephone Email address Bus. ( ) - Cell ( ) - For Office Use Only and Community Involvement On the chart provided, list the activities in which you participate (both in school and in the community) Activity Date/Duration Role e.g. Soccer Team May September attend practices and games – 2013 - present team work stay physically fit team captain in summer 2016
Current school you are attending and School Board Address Number Street Apt # City Province Postal Code Home Telephone Number ( ) - Date of Birth Student Contact email address (required – must check regularly) Parent/Guardian Contact Information (please print) 1. Parent/Guardian Last Name Given Name Telephone Bus. ( ) - Cell ( ) - address (required – must check regularly) 2. Parent/Guardian Last Name Given Name Telephone Bus. ( ) - Cell ( ) - Email address For Office Use Only and Community Involvement On the chart provided, list the activities in which you participate (both in school and in the community) Activity Date/Duration Role e.g. Soccer Team May – September 2013 - present attend practices and games team work stay physically fit team captain in summer 2016
Application%20Preparatory%20Program%20-%20full%20package%20%202017-2018.docx