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RAEC Adult Registration Form
Please fill out all parts of this form to register!
47
Questions
START
1
Are you currently living in Manitoba
*
This field is required.
YES
NO
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2
Full Legal Name
*
This field is required.
Your full legal name as listed on your birth certificate or Canadian government issued documents.
First Name
Middle Name(s)
Last Name
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3
Legal Name used in school
*
This field is required.
If your name has changed since you last attended school at any level, provide your previous name.
First Name
Middle Name(s)
Last Name
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4
Name Used/Preferred Name
*
This field is required.
Please enter the name you would like us to use
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5
Gender
*
This field is required.
Please Select
Female
Male
Undeclared/Other
Please Select
Please Select
Female
Male
Undeclared/Other
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6
Pronouns Used
*
This field is required.
Please select the pronouns you would like us to use for you
Please Select
They/Them
She/Her
He/Him
Please Select
Please Select
They/Them
She/Her
He/Him
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7
Email
*
This field is required.
Please tell us your email address. You will receive confirmation of your registration at this email address.
example@example.com
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8
Phone Number
*
This field is required.
Please tell us a phone number that you can be reached at.
Please enter a valid phone number.
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9
Birthdate
*
This field is required.
-
Date
Year
Month
Day
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10
Residential Address
*
This field is required.
Please share your home address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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11
Have you ever been a registered student in Border Land School Division?
*
This field is required.
YES
NO
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12
In which BLSD school were you registered?
*
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13
Are you currently registered at another Adult Learning Center?
*
This field is required.
YES
NO
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14
Which Adult Learning Centre are you currently registered at?
*
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15
Do you give us permission to communicate with your home school (the other adult learning center in which you are currently registered)?
*
This field is required.
YES
NO
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16
Mailing Address
*
This field is required.
Please share your mailing address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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17
Please provide identifying document
*
This field is required.
Options: MB Driver's License
OR
a combination of one government issued photo ID (Status Card, MB Identification Card, Passport)
AND
one proof of residential address (ie: MB Health Card, MB Hydro Bill, Lease Agreement etc.)
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Max. file size
: 10.6MB
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18
How did you hear about us?
*
This field is required.
Check all that apply
Google
Advertising
Friends/Family
University
Social Media (Facebook, Instagram, etc.)
Other
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19
Emergency Contact
*
This field is required.
Please provide contact information for who we should contact in case of an emergency.
First and Last Name of Emergency Contact
Emergency Contact Phone Number
Relationship
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20
Were you a RAEC student in the previous school year?
Did you register in the 2023/2024 school year?
YES
NO
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21
Did you attend a Manitoba Adult Literacy Program in the previous school year?
Did you attend a MALP in 2023/2024?
YES
NO
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22
Do you have a Canadian High School Diploma?
*
This field is required.
Are you a high school graduate?
YES
NO
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23
In which Canadian province was your diploma obtained in?
*
This field is required.
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please Select
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
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24
What year was your high school diploma obtained?
*
This field is required.
Tell us the year of your high school graduation.
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25
Do you have a high school diploma from a country other than Canada?
*
This field is required.
YES
NO
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26
In what Country was your diploma obtained?
Please tell us the country that you obtained your high school diploma in.
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27
What year was your Non-Canadian high school diploma obtained?
*
This field is required.
Please tell us the year of your high school graduation.
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28
Please upload a copy of your high school transcript
You can obtain a copy of your transcript from the last high school that you attended. If you completed credits in Manitoba, you can obtain a copy of your transcript from Manitoba Student Records. This information is essential for academic planning and will be required before beginning coursework.
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: 10.6MB
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29
How many years since you last attended school?
*
This field is required.
Select the option that best reflects how many years ago you last attended school?
Please Select
Within the last 5 years
6-10 years
11-20 years
More than 20 years
Please Select
Please Select
Within the last 5 years
6-10 years
11-20 years
More than 20 years
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30
What grade level have you completed?
*
This field is required.
Tell us the highest grade level that you have completed.
less than grade 8
grade 8 or 9
grade 10 or 11
grade 12 graduate
GED
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31
Are you a Canadian Immigrant?
*
This field is required.
YES
NO
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32
Did you immigrate to Canada within the past 5 years
*
This field is required.
YES
NO
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33
Is English your first language?
*
This field is required.
Is English the language you
first
learned from infancy?
YES
NO
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34
Language and Literacy Information
*
This field is required.
Primary Language Spoken:
Secondary Language Spoken:
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35
Upload Canadian Language Benchmark document AND/OR Canadian Literacy Stages document
*
This field is required.
Students who speak English as an additional language must have Canadian Language Benchmark level 8 (or equivalent)
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: 10.6MB
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36
Citizenship
*
This field is required.
Select the option that reflects your citizenship.
Please Select
Canadian Citizen
Permanent Resident
Study Permit
Work Permit
Visitor Record
Refugee Claimant
Please Select
Please Select
Canadian Citizen
Permanent Resident
Study Permit
Work Permit
Visitor Record
Refugee Claimant
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37
Please upload immigration status documents.
*
This field is required.
Temporary Residency, Permanent Residency, Work Permit, Study Permit etc.
Drag and drop files here
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: 10.6MB
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38
Refugee Status
*
This field is required.
Select the option that reflects your Canadian refugee status.
Please Select
Non-Refugee
Government Assisted refugee
Privately sponsered Refugee
Blended Visa Office Refugee
Refugee claimant
Please Select
Please Select
Non-Refugee
Government Assisted refugee
Privately sponsered Refugee
Blended Visa Office Refugee
Refugee claimant
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39
Citizenship Documentation Information
*
This field is required.
Citizenship document expiry (if applicable):
Country of origin:
Date of Immigration:
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40
Have you enrolled in a Canadian Public School since arriving in Canada?
*
This field is required.
YES
NO
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41
Are you of Indigenous descent?
*
This field is required.
Yes, I am First Nations
Yes, I am Inuit
Yes, I am Métis
Yes, I am uncertain of my ancestry
No
First language learned was an Indigenous language
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42
Please select up to 2 cultural-linguistic identities
Aboriginal - Other
Anishinaabe (includes Ojibway/Saulteaux)
Dakota
Dene
Ininiw/Ininew (Cree)
Inuktituq
Michif
Oji-Cree (includes Island Lake Dialect)
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43
Are you a single parent of children under the age of 6?
*
This field is required.
YES
NO
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44
Employment Status
*
This field is required.
Choose the option that best reflects your current employment status.
Please Select
Employment insurance (EI) recipient
Income Assistance (IA) recipient
Full-time employed
Part-time employed
Not employed: actively seeking work
Not employed: not actively seeking work
Long-term disability recipient
Workers compensation recipient
Receive a band-funded training allowance
Please Select
Please Select
Employment insurance (EI) recipient
Income Assistance (IA) recipient
Full-time employed
Part-time employed
Not employed: actively seeking work
Not employed: not actively seeking work
Long-term disability recipient
Workers compensation recipient
Receive a band-funded training allowance
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45
Biography
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This field is required.
Please write a short biography introducing yourself and telling us a little bit about your life story.
Include why you are coming back to school, courses you wish to take, and any potential goals you have for the future.
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46
By which date do you need to have your course(s) completed?
This particularly applies for students upgrading for a university or college program.
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Date
Day
Month
Year
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47
Signature
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This field is required.
I certify that the information I have provided is accurate and true to the best of my knowledge
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RAEC Registration 2025-2026
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