Ertyuh
YORK CATHOLIC DISTRICT SCHOOL BOARD
ADULT & CONTINUING EDUCATION DEPARTMENT
Pending Approval
YCDSB CREDIT COURSE REGISTRATION FORM
(YCDSB STUDENTS GRADES 9-12)
SCHOOL INFORMATION
Program: Summer Fall Winter PLAR Saturday IL After School
Father Bressani CHS School Location: __________________________________________________ Father Bressani CHS Home school: ____________________________________________________
Passport No.
(GEO program only)
979629268 OEN Number: __________________________________________ 9 Current Grade: _______________
Last school attended:
(if not currently in school) __________________________________________________
__________________________________________________
STUDENT INFORMATION
Last name: ____________________________________________________________ Lochner Birth date: ______________________________________ January 6, 1998 Age: ________ Sex: M F
Stephanie First name: ____________________________________________________________ 73 Sunset Ridge Street address: _________________________________________________________ Woodbridge Town/City: ____________________________________________________________
(905)893-1484 Home phone no.: ____________________________
Email address: steffieloc@rogers.com (mandatory): _______________________________________
L4H 1W1 Postal Code: ______________________________________
Other : ____________________________
Cell phone no.: __________________________
Parent/Guardian Contact Details: ______________________________________________________________________________________________ Canadian Citizen: Medical conditions/allergies: Visa student: Landed Immigrant: Other:
_______________________________________________________________________________________________
SCHOOL COURSES REQUESTED
Principles of Mathematics Course Title: _______________________________________________________________
Course Title:
ADULT & CONTINUING EDUCATION DEPARTMENT
Pending Approval
YCDSB CREDIT COURSE REGISTRATION FORM
(YCDSB STUDENTS GRADES 9-12)
SCHOOL INFORMATION
Program: Summer Fall Winter PLAR Saturday IL After School
Father Bressani CHS School Location: __________________________________________________ Father Bressani CHS Home school: ____________________________________________________
Passport No.
(GEO program only)
979629268 OEN Number: __________________________________________ 9 Current Grade: _______________
Last school attended:
(if not currently in school) __________________________________________________
__________________________________________________
STUDENT INFORMATION
Last name: ____________________________________________________________ Lochner Birth date: ______________________________________ January 6, 1998 Age: ________ Sex: M F
Stephanie First name: ____________________________________________________________ 73 Sunset Ridge Street address: _________________________________________________________ Woodbridge Town/City: ____________________________________________________________
(905)893-1484 Home phone no.: ____________________________
Email address: steffieloc@rogers.com (mandatory): _______________________________________
L4H 1W1 Postal Code: ______________________________________
Other : ____________________________
Cell phone no.: __________________________
Parent/Guardian Contact Details: ______________________________________________________________________________________________ Canadian Citizen: Medical conditions/allergies: Visa student: Landed Immigrant: Other:
_______________________________________________________________________________________________
SCHOOL COURSES REQUESTED
Principles of Mathematics Course Title: _______________________________________________________________
Course Title: