Grade 10-12 Online Registration Students » Registration » Grade 10-12 Online Registration Student Registration Form Carlton Comprehensive High School Step 1 of 4 25% Student Personal InformationSchool Year*School Year2018-2019 (semester 2)2019-2020Program Type*ProgramRegular ProgramFrench ImmersionOtherStudent Legal Name* First Name Middle Name/Initial Last Name Date of Birth* GenderGenderMaleFemaleUnspecifiedGrade*Grade10 - Ten11 - Eleven12 - TwelveA12Mailing Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Student's Email Address Student's Cell PhoneLast School AttendedPlease complete only if the student is new to this school.Name of School*GradeTeacherAddress of SchoolPhone Parent or Guardian InformationParent/Guardian Name 1* First Last Relationship*(Father, Mother, Guardian, Step-father, Step-mother)Does this student live with you?*YesNoEmployerEmployer PhoneParent/Guardian 1 Cell PhoneParent/Guardian 1 Email Relationship(Father, Mother, Guardian, Step-father, Step-mother)Parent/Guardian Name 2 First Last Does this student live with you?YesNoEmployerEmployer PhoneParent/Guardian 2 Cell PhoneParent/Guardian 2 Email I wish to be notified of student's absence via*(pick one)E-mailCell PhoneHome PhoneEmergency InformationParents will always be contacted first in the event of an emergency.Emergency Contact 1 NameIf parents are unavailable First Last Home PhoneWork PhoneCell PhoneEmergency Contact 2 NameIf parents and Emergency Contact 1 are unavailable First Last Home PhoneWork PhoneCell PhoneDoctor's NameDoctor's PhoneSask. Hospitalization NumberDoes this student have a severe or life threatening medical condition?*YesNoPlease provide details of the medical conditon Siblings informationPlease contact the school to list more than two siblings.Sibling 1 Name First Last Date of Birth Sibling 2 Name First Last Date of Birth Custody InformationShould school administration be aware of any Court Order for the protection of your child?*In rare instances a child may be designated as “Protected” if a court has issued a restraining order. If you answered YES, please make arrangements to discuss this situation with the school administration.YesNoIs this student in foster care?*YesNoFoster Care AgencyMinistry of Social ServicesICFS (Indian Child and Family Services)Type of Foster CareRegularTherapeuticTherapeutic GroupSocial Worker's Name First Last Social Worker's PhoneCitizenship InformationCitizenshipIf other than CanadianCountry of BirthIf other than CanadaLanguage spoken in the homeIf other than EnglishStudent AncestryVoluntary InformationDo you consider this student to be an Aboriginal person?Aboriginal people are those who identify themselves to be Registered/Treaty/Status Indian, Métis, or Inuit. Based on this definition, do you consider this student to be an Aboriginal person?YesNoPlease specify the Aboriginal GroupRegistered/Treaty/Status IndianMétisInuitBand Name and Treaty No.If this student is living on reserve, please provide the name of the reserve? Course SelectionsPlease refer to our online course selection handbook. Our school operates on a two-semester system, with a maximum of five classes per semester. Please indicate below in which classes you would like to be enrolled. Not all requests will be able to be accomodated.Class OneClass TwoClass ThreeClass FourClass FiveClass SixClass SevenClass EightClass NineClass TenPermission1. I give permission for my son/daughter to participate in low risk educational activities that occur during normal school hours away from the school grounds. I understand that the activities will be connected to educational objectives. The school will inform me by written note or telephone call when a trip will occur.*YesNo2. I give permission for my child's personal information (name, grade, school), photo, video recordings, and/or work to be displayed beyond the school or school division and know that it will be accessible to the public through a posting, publication, or internet website.*Local Authority Freedom of Information Protection (LAFOIP) Please read the LAFOIP brochure available at the school or online at www.srsd119.ca (click on Parent Information)YesNoSignatureI hereby declare that I have read and understood the information contained on this Student Registration Form and that the information I have provided is correct. I understand it is my responsibility to inform the school of any changes to the information contained on this form.Date Digital Signature*By typing your name and clicking submit, you agree that this will stand in place of your signature.Section Break This iframe contains the logic required to handle Ajax powered Gravity Forms.