Course Registration Form

UPDATE Student or parent can now complete form. school Administrator’s, Community Leader, physician, council member or PS worker please refer. Student Registration Form
Student Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
Mailing address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Student phone number

Area Code Phone Number
Teacher/Administrator/Parent E-mail *
Mobile Number *

Area Code Phone Number
Work Number

Area Code Phone Number
Teacher Administrator or Parent name *
Courses
Additional Comments/pupil number if you have it
Should be Empty:

UPDATE Student or parent can now complete form. school Administrator’s, Community Leader, physician, council member or PS worker please refer. Student Registration Form