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Triangle Program Intake Meeting Form
Please complete the following form to set up an intake meeting for possible registration at Triangle Program.

This form needs to be completed by a legal guardian, unless the student is over 18.

You can find more information at http://triangleprogram.ca

Filling out this form DOES NOT register a student into the program.
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Email *
Student First Name (Chosen) *
Student legal last name
 *
Student's pronouns
When did you want to start at the Triangle Program? 
 *
Student Birthday *
MM
/
DD
/
YYYY
Guardian full name (if student under 18)
Guardian contact number (if 18 or over, enter student's number) *
Guardian contact email (If 18 or over, student email)
 *
The following information will only be shared with Triangle Staff members and does not give us permission to share this information with any other organization.
Provide a brief summary of the student's academic history including schools attended, attendance patterns, engagement with coursework / teachers / peers.
If applicable, list any known learning exceptionalities and/or current accommodations.
If applicable, provide a brief summary of the student's experience of mental health as it relates to their engagement with school.
If applicable, list any accessibility needs (eg. assistive devices, allergies, sensitivities, etc.)
If applicable, list any other agencies / services the student is currently connected with (eg. housing, educational, mental health). Please include agency name and contact information.
Please email the most up to date Student Status Sheet, IEP, and VP referral form (found at http://triangleprogram.ca/admissions/) , and email to ashley.fullbrook@tdsb.on.ca 
 *
Required
We will follow up by the email provided to arrange an intake meeting after receiving the required documentation. If you have any additional questions at this time please let us know.
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