Continuing Education Co-op Registration

Please complete the form below. Required fields marked with an asterisk *

Course Registering (check all that apply)*

Answer Required

CDSBEO Co-op Education Course- Adult/OYAP (18+ ONLY)

CDSBEO Co-op Course High School Student- SHSM/Credit

First Name*

Answer Required

Last Name*

Answer Required

Date of Birth*

Answer Required

Gender*

Answer Required

Male

Female

Prefer not to specify

O.E. N. (if known):

Answer Required

Email Address*

Answer Required

Parent email address (if under 18)

Answer Required

Mobile Phone (no spaces or dashes)*

Number Required

Address

Street Address*

Answer Required

City*

Answer Required

Postal Code*

Answer Required

Township

Answer Required

First Language*

Answer Required

English

French

Other

Country of Last Residence*

Answer Required

Canada

Other

If other, please specify.

Answer Required

Country of Birth*

Answer Required

Canada

Other

If other, please specify.

Answer Required

If born in Canada, Province/Territory of Birth

Answer Required

User of Information and Image: Do you consent to being photographed or videotaped, and your name, image and/or school work used in media coverage of school related events or board publications, or on the school or board website or Facebook page? *

Answer Required

I do consent.

I do not consent.

VOLUNTARY FIRST-NATION, MÉTIS, and INUIT SELF-IDENTIFICATION - All parents/guardians of Indigenous students, and students aged 18 years or older, have the right to voluntarily and confidentially self-identify. Through self-identification the Board is able to collect relevant information which helps to provide programs and strategies supporting the needs of First Nations, Métis and Inuit learners. This information is being gathered in accordance with section 29(2) of the Municipal Freedom of Information and Protection of Privacy Act.*

Answer Required

First Nation

Metis

Inuit

None of the above

I do not wish to disclose.

Former High School (if your last school attended was CDSBEO eLearning School or the PSW program, please select St. James Catholic Education Centre) *

Answer Required

If the last school attended was not a CDSBEO school, what is the name of the last high school you attended?

Answer Required

What town/city is this high school located?

Answer Required

If you did not attend a CDSBEO high school, please email the following to [email protected]:

1) A copy of your Canadian Birth certificate or Immigrant/Refugee status forms

2) A copy of your high school transcript

3) Proof of mailing address

If you have a copy of your high school transcript, please upload it here:

Answer Required

Choose a file or drag it here.

Identify the last grade you completed:*

Answer Required

Have you obtained your Ontario Secondary School Diploma (OSSD)?*

Answer Required

Yes

If you have obtained your OSSD, which school did you graduate from?

Answer Required

If you have not obtained your OSSD, do you plan to earn your OSSD (graduate) at the end of this summer?

Answer Required

What value of co-op are you registering for?

Answer Required

1 credit

2 credit

3 credit

4 credit

What courses are you hoping to link the co-op to? (separate course codes with a comma- if unsure, leave blank)

Answer Required

What is the location of your placement? (Can be location of employment)

Answer Required

Name of the main point of contact for the co-op placement?

Answer Required

Phone number of the main point of contact for the co-op placement?

Answer Required

Permission to register.*

Answer Required

You are under 18 years of age and parent/guardian has given you permission to register.

You are over the age of 18.

Please fix the highlighted areas below before submitting.

Continuing Education Co-op Registration