Off Campus Education - Pre-Registration Form
To register in an Off Campus program, please complete this form alongside the Initial Forms Package on the Palliser Off Campus Education website and submit completed to your Off Campus Coordinator.
Last name *
Your answer
First name *
Your answer
What school are you from? *
What grade are you currently in? *
When will you graduate? June of ... *
What's your cell number?
Your answer
What's your email address? (please include your address as well as your personal address if you use a different one) *
Your answer
What is your parent's name?
Your answer
What is your parent's phone number (and cell number)?
Your answer
What is your parent's email address?
Your answer
What Off-Campus program are you interested in? *
Do you currently have a place to do work experience (paid or volunteer)? *
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