Registration for 10 - 12

* - Required field

I am remaining enrolled in another school.
	Name of school:
		I understand that my current school administrator must email the registrar to approve my course selection.
I am not remaining enrolled in another school.
	Name of last school attended:
	Location of last school attended:	(Enter "none" if you were not at another school)
	Date last attended:

The Applicant confirms that the information in this form is accurate and complete, that the Applicant has the legal right to enroll the student in NIDES, and that the Applicant understands that no materials will be forwarded until fees and deposits (where applicable) are paid; that work required will be completed and returned as directed; and that enrollment remains valid for one year.	I agree
The Applicant confirms the legal guardian, student, and home facilitator’s commitments to working together with NIDES in completing the coursework agreed to by all parties during the normal academic calendar (unless otherwise negotiated). Working together is defined by consistent activity in courses (unless previously agreed to, consistent activity is defined as weekly submissions according to the personal education plan of the student) and continuous communication with the NIDES teachers (weekly).	I agree
The Applicant understands that if the student is inactive, he/she may be withdrawn from the course.	I agree
The Applicant understands that for some secondary courses, there are unit tests and exams that will require a test center. If the applicant attends a secondary school, this is the location where he/she will write tests. If not, NIDES has test centers established on north Vancouver Island. Students outside this region will be responsible for any costs associated with test supervision.	I agree
If using NIDES computers and/or online services, the Applicant agrees that the Internet access only be for educational and lawful purposes.	I agree
The Applicant hereby authorizes the release of all previous records to the North Island Distance Education School, and authorizes North Island Distance Education School to report to schools, school districts, or post-secondary institutions where records exist.	I agree
I declare that I am ordinarily resident in British Columbia and if I am traveling outside of the province of BC, I will inform the registrar (registrar@nides.bc.ca) in writing of my intended return date to British Columbia.	I agree
By completing this form and submitting it, it is assumed that the Applicant agrees to the above conditions of enrollment.	I agree

Questions/Comments:

A. Student Information
*Start Date	Immediate September Other, please specify:
*Legal Surname		Usual Surname
*Previous Surname(s) (Enter "none" if student does not have a previous surname)
*Legal FIRST Name		Usual First Name
*Legal MIDDLE Name	(Enter "none" if student does not have a middle name)	*Gender	Male Female
*Legal MIDDLE Name	(Enter "none" if student does not have a middle name)	*Date of Birth
*Telephone - Home		Fax
Telephone - Work		*Student's Email	(Enter "none" if student does not have email)
*Resident of British Columbia?	Yes No	*Parent/Guardian Email	(Enter "none" if parent/guardian does not have email)
NIDES can accept these students, who currently reside in British Columbia. (Those traveling temporarily outside of BC are eligible.) BC residents are tuition free. International students in BC will pay appropriate tuition.
*Select the student citizenship status:	Canadian Citizen Landed Immigrant International Student in a BC School (Name of school: )
NOTE: Please make sure to include any PO boxes, suite #’s etc... or any information we will need to ship you materials.
*Home Address		Mailing Address (if different)
*City		City
*Province		Province
*Country		Country
*Postal Code		Postal Code
*First & Last name of Parent/Guardian	(Enter NA if not applicable)	*Relationship	(Enter NA if not applicable)
		Address & Phone if different from student's
First & Last name of Parent/Guardian		Relationship
		Address & Phone if different from student's
*First Nations, Metis, Inuit Aboriginal Ancestry?	None Status - On Reserve Status - Off Reserve Non Status Metis Inuit
B. Education
*Has student received Learning Assistance?	Yes No	Learning Assistance areas of focus:
*Has student had an Individual Education Plan?	Yes No I Don't Know	If there was an IEP, when was it done? (YYYY-MM-DD)
If your child is new to NIDES, and you have answered yes to any of the above questions, complete and submit this signed release by fax, mail or drop off to NIDES.
*Do you have a computer?	Yes, personal computer Yes, NIDES computer No	*Has there been a Psycho-educational Assessment?	Yes No I Don't Know
Are you requesting a NIDES computer? ($100 deposit required)	Yes No (only available to full-time NIDES students)	*Do you have an internet connection?	No Dial-up High-Speed
*Grade you last completed:	None K 1 2 3 4 5 6 7 8 9 10 11 12 Graduated
*Are you currently taking a course at NIDES?	Yes No

Please select the courses that you are activating now: ( = Online, = Paper, = Rosetta Stone - Online)
Accounting 11 Art 10 (Visual Arts 10) Biology 11 Biology 11 Biology 12 Business Computer Applications 11 Business Information Management 12 CAPP 11 CAPP 11 CAPP 12 CAPP 12 Career and Personal Planning for Adults 12 Chemistry 11 Chemistry 11 Chemistry 12 Communications 11 Communications 12 Communications 12 Data Management 12 Earth Science 11 English 9 (Students in Gr 10 and up) English 9 (Students in Gr 10 and up) English 10	English 10 English 11 English 11 English 12 English 12 English Literature 12 English Literature 12 Entrepreneurship 12 Family Studies 12 First Nations Studies 12 Food Studies 11 Food Studies 11 Food Studies 12 Geography 12 Grad Transitions History 12 Information Technology 10 Information and Communications Technology 11 Information and Communications Technology 12 Law 12 Math 9 Principles (Students in Gr 10 and up) Math 10, Foundations and Pre-Calculus 10 Math 10, Apprentice and Workplace	Math 11, Applications Math 11, Essentials Math 11, Principles Math 12 Principles Orientation 11 (2 credits) Photography 11 Physical Education 10 - 20 week course Physical Education 11 - 20 week course Physical Education 12 - 20 week course Physics 11 Physics 11 Physics 12 Planning 10 Science 9 (Students in Gr 10 and up) Science 10 Science 10 Social Studies 9 (Students in Gr 10 and up) Social Studies 10 Social Studies 11 Social Studies 11 Studio Arts: Drawing & Painting 11 Writing 12
Languages

Please select the courses that you are activating now: ( = Online, = Paper, = Rosetta Stone - Online)
	Arabic 11 Arabic 11, Intro Dutch 11 Dutch 11, Intro Filipino (Tagalog 11 Filipino (Tagalog) 11, Intro French 10 French 10 French 11 French 11 French 12 German 11, Intro German 11 German 12 Greek 11, Intro Greek 11	Hebrew 11, Intro Hebrew 11 Hindi 11, Intro Hindi 11 Italian 11, Intro Italian 11 Japanese 11, Intro Japanese 11 Korean 11, Intro Korean 11 Latin 11, Intro Latin 11 Mandarin Chinese 11, Intro Mandarin Chinese 11 Polish 11, Intro Polish 11	Portuguese 11, Intro Portuguese 11 Russian 11, Intro Russian 11 Spanish 11, Intro Spanish 11, Intro Spanish 11 Spanish 11 Spanish 12 Swedish 11, Intro Swedish 11 Vietnamese 11, Intro Vietnamese 11