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Summer School - Registration form for Non-DCDSB students

Select one option:

Current Secondary school students must ask their Guidance Consellor for a transcript or credit history that is stamped with the school address and signed by the Guidance Counsellor for approval to take a summer school course. This must be attached below to complete the registration process.

Surname:

First Name:

Preferred Last Name:

Preferred First Name:

Middle Name:

Date of Birth:

Gender (please select):

Gender - Prefer to Specify:

OEN:

Address:

City:

Postal Code:

Current Phone #:

Student Email Address:

Country of Birth:

Province of Birth:

If not born in Canada, date of entry (MM/dd/yyyy):

Citizenship Status:

If you are not a Canadian Citizen, you must provide proof of Canadian Resident Status, Landed Immigrant Status or Student Visa Status.

Aboriginal Ancestry:

First Language Spoken:

Parent/Guardian or Emergency Contact Details

Contact Name:

Contact Number:

Email Address:

Current/Previous Education

Do you have your high school diploma:

If yes, what year did you graduate:

Graduating School:

If you have not obtained your high school diploma, what is the name of the current/last high school you attend(ed):

City of School:

Year:

Have you been a student with the Durham Catholic District School Board before:

Course Type you are Registering in:

Please specify the course code(s) you are registering for:

Does the student have an IEP?

Attach IEP:

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Attach Photo ID:

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Attach transcript or credit history:

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Attach citizenship document if born outside Canada:

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