eLearning Summer School Registration Form UCC

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Note: Completion of this form does NOT guarantee enrolment in a requested course. Your guidance counsellor will inform you if your course requests are not available or if you are not eligible to take the course due to missing pre-requisites. MONITOR EMAIL DAILY.

First Name:

Last Name:

Select your CURRENT grade

Which course do you wish to take this summer? Be sure to identify the grade, subject and level (eg. Grade 11 University English; Gr.10 Civics/Careers; Gr.12 College English)

Why are you wishing to take this course? Check any that apply.

Fast track a course/ Reach ahead opportunity

Repeat a failed course

Making a stream change (ie. College to University)

Taking a course not offered in my school

Other:

If you complete this summer course successfully, what course would you like to have in your timetable next year? Please suggest TWO options as there is no guarantee you will get your first choice.

Home Phone Number:

Cell Number:

Email for summer use:

Parent name:

Parent email:

Date of birth:

YYYY

Address:

City:

Postal code:

Do you have an Individual Education Plan (IEP)?

Clear selection

Citizenship:

Canadian citizen

First Nations Status

Other:

Clear selection

Counsellor:

Ms. Bromley (Last names A-F)

Ms.Fisher (Last names G-M)

Mr. Matteis (Last names N-Z)

Clear selection

Submit

Clear form

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