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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