{field:program_interest_1}

{field:academics_program_1} {field:careers_certificate_program_1}{field:trades_program_1} {field:other_program_1}

Application Date: {other:date}

Reference ID: {field:shared_id_1}

Application Overview

Full Name: {field:first_name_1} {field:middle_name_1} {field:last_name_1}
Birthdate: {field:birthdate_1}
Email: {field:student_email_1}
Primary Phone: {field:student_primary_phone_1} ({field:student_primary_phone_type_1})
Secondary Phone: {field:secondary_student_phone_1} ({field:secondary_student_phone_type_1})

Grade: {field:present_grade_1}
School: {field:present_school_1:label}
Out of District: {field:out_of_district_1}
Graduation Year: {field:graduation_year_1}
Counsellor Email: {field:present_school_1}

{field:freedom-information-checkmark} By submitting this application, {field:first_name_1} {field:last_name_1} acknowledges that they have read and understand the Freedom of Information and Protection of Privacy for the Careers Education Department:

Career Education Program Application