Student Information Form

eLearning Student Information Form

DO: Students, complete this form, save it and email it to

DO: Emailed the form: YES ___

No ____

(check one)

THIS IS NOT A REGISTRATION FORM! Sending this form to Continuing Education does

not mean you are registered for the course.

Once you have emailed the form to the

email address above, submit this form to your Guidance Counsellor.

Student name:

Student number:

Name of Day School:

Guidance Counsellor name:

Course code (e.g. ENG4U):

Student email address:

Student cellphone number:

Parent/Guardian email address:

Parent/guardian work number(s):

Parent/guardian cellphone number(s):

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Parent category: Business