KSSEP Student Registration Form
Have you participated in the KSSEP in the past? *
Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Address *
Your answer
Band Number *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Social Insurance Number *
Your answer
Medicare Number *
Your answer
Allergies
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Name *
Your answer
Select the option which applies to you *
I am registered with the Kahnawake Education Center (Applicants who are entering or continuing in post-secondary studies) *
Date of Return to School (if day is unknown, select the 1st of the return month) *
MM
/
DD
/
YYYY
School Name *
Your answer
School Year/Level *
Your answer
What is your program of study/major, or what grade will you be entering? *
Your answer
Please email your CV to onawa.jacobs@kedc.biz. If you are a graduate starting CEGEP or university, please also include a scan of your acceptance letter. Include your name and "KSSEP 2018 Student Registration" in the subject line.
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