Grade 7/8 Remedial Language Arts & Mathematics 2017 Summer School Registration Form
PLEASE NOTE:

This registration form is for students at Nipissing-Parry Sound Catholic District School Board only.

Student Information
First Name
Please use complete first name as it appears on report card
Your answer
Last Name
Please use complete last name as it appears on report card
Your answer
Date of Birth
Use the drop down menu to choose the correct date.
MM
/
DD
/
YYYY
Gender
Mailing address
Street Number & Name
Your answer
City/Town
Your answer
Postal Code
please use the format X1X X1X
Your answer
Present School
Grade
Teacher Name
Your answer
Parent/Guardian Name
Your answer
Telephone (home)
please use the format (000)-000-0000
Your answer
Telephone (business/mobile)
please use the format (000)-000-0000
Your answer
Parent/Guardian Email Address
Your answer
Medical Concerns:
Your answer
IPRC Designation
(If applicable)
Your answer
Emergency Contact Name:
Your answer
Emergency Contact Telephone
please use the format (000)-000-0000
Your answer
Submit
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