CAEC (Canadian Adult Education Credential)Tutoring Registration
Adult Learrning Centre Room 103B- 111 54th Street, Provincial Building Edson, AB
Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number we can contact you at..
Email
*
example@example.com
Year of Birth
*
Gender
*
Female
Male
Prefer not to disclose
Where do you live?
*
Town of Edson
Rural / Yellowhead County
Will you travel more than 50 km to attend?
Yes
What is your Status in Canada
*
Canadian Citizen
Permanent Resident
Temporary Foreign Worker / Refugee
First Nations / Metis
Highest Level of Education Completed
*
Grade 9 or lower
Grade 9
Grade 10
Grade 11
complete some Grade 12 level courses
How did you learn about this program?
*
social media
website www.edsonlearning.ca
poster
friend / family
employer / co-worker
referral from another agency / organization
If you were referred by another agency, please provide the name.
Do any of the following make it difficult for you to attend:
the registration fee
lack of transportation
lack of childcare
Do you have any other concerns?
What are your learning objectives? What are you hoping to achieve?
*
Disclosure
The information collected will help the Edson and District Community Learning Society to develop your learning plan. It is required for program reporting and is confidential. I agree to an exit interview/survey when I have completed my program. These interviews help the Learning Center maintain and apply for new course opportunities for students.
Signature
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