Trailhead Student Application Form: Grade 10
Please complete and submit this form if you wish to apply for the Trailhead program. Please ensure that you have correctly entered individual names and email addresses. Errors, or incorrect information may delay your application.

Trailhead is a program offered by the Halton District School Board and managed by Gary Allan High School. For more information, go to http://trailheadprogram.org

First Name *
Your answer
Legal Last Name *
Your answer
For what academic year are you applying? *
O.E.N. *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Current Grade *
Your answer
Street Adddress *
Your answer
City *
Your answer
Province *
Your answer
Postal Code *
Your answer
Student's e-mail *
Your answer
Home School *
If "Other..." was selected above, please enter name of referring school:
Your answer
Referencing Teacher's Name *
Your answer
Referencing Teacher's e-mail *
Your answer
Guidance Counsellor's Name *
Your answer
Guidance Counsellor's e-mail: *
Your answer
Parent/Guardian's e-mail *
Your answer
Parent/Guardian's Phone Number *
Your answer
How many credits should you have at the end of this school year *
Your answer
Which English credit will you take? *
Which semester would you like to attend? (We will do our best to accommodate your choice) *
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