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10 – 12 Enrollment Form Page
IT Support
2021-03-16T19:17:11+00:00
10 – 12 ENROLLMENT
Grades 10 - 12 Enrollment Form 2021/22
Step
1
of
12
- Introduction
8%
Welcome!
You are about to start the 10 - 12 enrollment form for CHEK ABC's distributed learning program. We will guide you through this process step by step. If you need to navigate back and forth between pages on the form please be sure to use the "previous" and "next" buttons at the bottom of the pages so that any information entered remains saved.
Please include the following with your application. These documents are necessary for the enrollment process: Your child will not be considered for enrollment until we receive these documents.
- Student Birth Certificate or Passport
- Immigration documents (if applicable, please include parents work permit and birth certificate/passport)
-
Ordinarily resident form
completed and signed
if family will be outside of BC for 6 weeks or more of the year.
-
Records Request Form
printed and signed
If there are any files that you would like to submit with this online application, there will be a space to upload these files at the end of the application.
Please note that if you withdraw your child(ren) prior to September 30, there will be a $100 withdrawal fee per child.
If you have any questions about completing this form please call us at 250-352-0526 or email
admissions@chekabc.ca
.
Today's Date
*
MM slash DD slash YYYY
Parent/Guardian Details
Please enter parent name and contact details.
First Name
*
Last Name
*
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Self
Other
Email
*
Primary Phone Number
*
Cell Phone
Landline
Please enter cell phone number
*
Please enter landline phone number
*
Secondary Phone Number
*
Cell Phone
Landline
No Secondary Phone Number
Please enter cell phone number
*
Please enter landline phone number
*
Is The Student Currently Living With Both Parents?
*
Yes
No
Provide Details Of Second Parent
First Name
Last Name
Relationship to Student
Please Select
Mother
Father
Legal Guardian
Other
Primary Contact Number
What Is Your Citizenship Status In Canada?
Please Select
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Are You Currently A Resident Of British Columbia?
*
Yes
No
If not, please explain
Do you plan to travel outside of BC for 6 weeks or longer during the school year?
*
Yes
No
If yes, please describe.
*
Please complete the
Ordinarily Resident form
and submit it with your other documents.
Provide Your Home Address
*
Street Address
City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Provide Your Mailing Address
Shipping Address - Please provide the address where school resources such as textbooks and report cards should be mailed to.
The same as Home Address
Mailing Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
How Did You Hear About Us? (optional)
Please Select
Please Select
Advertising
Social Media
Church
Event
Word of Mouth
Other
Which Church Do You Attend? (optional)
Church Name
City
Society Membership
Would you like to become a member of the Nelson Christian School Society?
*
Yes
No
Thank you for your willingness to support Nelson Christian School Society and to further Christian education across BC! There is a $25.00 fee to become a member of the Nelson Christian School Society. Unless you indicate differently, this will be deducted from your family's school based funds.
The Society Constitution and Bylaws
are attached for your late night reading enjoyment!
Student Details
Legal Name
*
Legal First
Legal Last
Middle Name
Middle
Preferred Name
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling the student in.
School Year
*
Please Select
2021 - 2022
Grade
*
Please Select
Grade 10
Grade 11
Grade 12
What diploma/certificate is your child working towards?
*
Please Select
Dogwood Diploma
Evergreen Certificate
Not Sure
If you are unsure, please
click here
for more information about certificates of graduation.
Please Provide Student's PEN (if known)
Student PEN (Personal Education Number)
Additional Student Information
Student Email Address
Student Phone Number
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Other
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
Student's Previous School
*
School Name
Town/City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Student History
Comment on your child's academic progress
Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?
*
Yes
No
Please explain and provide a copy of the most recent assessment with your documentation.
*
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
BC Medical Number
*
I don't have a BC Medical Number
Have you recently applied for a BC medical number?
Yes
No
Provide medical number for previous province
Are there any allergies or medical concerns?
*
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Emergency Contact Person (other than parent)
*
Name
Email Address
Phone
Relationship to student
Additional Info
Will you be enrolling a second student?
*
Yes
No
Student Details
Legal Name
*
Legal First
Legal Last
Middle Name
Middle
Preferred Name
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling the student in.
School Year
*
Please Select
2021 - 2022
Grade
*
Please Select
Grade 10
Grade 11
Grade 12
What diploma/certificate is your child working towards?
*
Please Select
Dogwood Diploma
Evergreen Certificate
Not Sure
If you are unsure, please
click here
for more information about certificates of graduation.
Please Provide Student's PEN (if known)
Student PEN (Personal Education Number)
Additional Student Information
Student Email Address
Student Phone Number
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Other
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
Student's Previous School
Same as first student
*
School Name
Town/City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Student History
Comment on your child's academic progress
Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?
*
Yes
No
Please explain and provide a copy of the most recent assessment with your documentation.
*
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
BC Medical Number
*
I don't have a BC Medical Number
Have you recently applied for a BC medical number?
Yes
No
Provide medical number for previous province
Are there any allergies or medical concerns?
Are there any allergies or medical concerns?
*
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Additional Info
Will you be enrolling a third student?
*
Yes
No
Student Details
Legal Name
*
Legal First
Legal Last
Middle Name
Middle
Preferred Name
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling the student in.
School Year
*
Please Select
2021 - 2022
Grade
*
Please Select
Grade 10
Grade 11
Grade 12
What diploma/certificate is your child working towards?
*
Please Select
Dogwood Diploma
Evergreen Certificate
Not Sure
If you are unsure, please
click here
for more information about certificates of graduation.
Please Provide Student's PEN (if known)
Student PEN (Personal Education Number)
Additional Student Information
Student Email Address
Student Phone Number
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Other
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
Student's Previous School
Same as first student
*
School Name
Town/City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Student History
Comment on your child's academic progress
Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?
*
Yes
No
Please explain and provide a copy of the most recent assessment with your documentation.
*
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
BC Medical Number
*
I don't have a BC Medical Number
Have you recently applied for a BC medical number?
Yes
No
Provide medical number for previous province
Are there any allergies or medical concerns?
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Additional Info
Will you be enrolling a fourth student?
*
Yes
No
Student Details
Legal Name
*
Legal First
Legal Last
Middle Name
Middle
Preferred Name
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling the student in.
School Year
*
Please Select
2021 - 2022
Grade
*
Please Select
Grade 10
Grade 11
Grade 12
What diploma/certificate is your child working towards?
*
Please Select
Dogwood Diploma
Evergreen Certificate
Not Sure
If you are unsure, please
click here
for more information about certificates of graduation.
Please Provide Student's PEN (if known)
Student PEN (Personal Education Number)
Additional Student Information
Student Email Address
Student Phone Number
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Other
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
Student's Previous School
Same as first student
*
School Name
Town/City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Student History
Comment on your child's academic progress
Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?
*
Yes
No
Please explain and provide a copy of the most recent assessment with your documentation.
*
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
BC Medical Number
*
I don't have a BC Medical Number
Have you recently applied for a BC medical number?
Yes
No
Provide medical number for previous province
Are there any allergies or medical concerns?
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Additional Info
Will you be enrolling a fifth student?
*
Yes
No
Student Details
Legal Name
*
Legal First
Legal Last
Middle Name
Middle
Preferred Name
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling the student in.
School Year
*
Please Select
2021 - 2022
Grade
*
Please Select
Grade 10
Grade 11
Grade 12
What diploma/certificate is your child working towards?
*
Please Select
Dogwood Diploma
Evergreen Certificate
Not Sure
If you are unsure, please
click here
for more information about certificates of graduation.
Please Provide Student's PEN (if known)
Student PEN (Personal Education Number)
Additional Student Information
Student Email Address
Student Phone Number
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Other
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
Student's Previous School
Same as first student
*
School Name
Town/City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Student History
Comment on your child's academic progress
Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?
*
Yes
No
Please explain and provide a copy of the most recent assessment with your documentation.
*
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
BC Medical Number
*
I don't have a BC Medical Number
Have you recently applied for a BC medical number?
Yes
No
Provide medical number for previous province
Are there any allergies or medical concerns?
*
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Parental Permission
I permit my child's name and photo to be used in school publications (ie. school newsletters), both electronic and paper.
*
Yes
No
I permit my child to be included in any media coverage of a school event.
*
Yes
No
Agreement
I/We are willing to support the school, the decisions of the Principal and the regulations passed by the school board.
*
Yes
No
Please type your full legal name to the above statement. In this instance, typed names suffice as a handwritten signature.
Course Engagement Contract
At CHEK ABC , it is expected that students will actively engage in all aspects of their online courses. This may include, but is not limited to, the following. Each section must be read through and please check off each box when you have done so. The form must also be dated and signed at the bottom.
Ownership of Learning:
*
We believe that students should take ownership of their learning and we promote student autonomy and independence. Students will:
- Become familiar with course content, expectations and assessment procedures.
- Initiate contact with teachers if help is needed.
- Use appropriate technology to interact with the teacher, and use feedback and consultation to develop and refine knowledge, skills, and attitudes.
- Submit their own work (see Plagiarism below).
- Research answers to questions and problems, and provide a bibliography or works cited list to show evidence of research.
- Participate and actively engage in all available learning activities in all units (reading texts, watching videos, doing practice questions, creating study notes when applicable, etc).
- Complete ALL assignments (except with special approved exemption from the teacher), online quizzes and supervised assessment in detail.
- Set personal goals in the Core Competency areas as required.
- Commit to working on the course consistently and submit assignments in a timely manner. The minimum is one assignment per month. If a student does not submit any work for an entire reporting period, the teacher may withdraw the student from the course and he or she cannot re-enroll in that course until the next semester.
I have read through, and agree to uphold the Ownership of Learning statements.
The Role of the Teacher:
*
We believe that teachers should empower students and promote independent research, evaluation, self-development, autonomy and life-long learning. Teachers will:
- Mark assignments and provide prompt and constructive feedback within a week.
- Be aware of individual student differences when designing courses and make adaptations as necessary.
- Be available to students for:
- questions of clarification.
- minor further instruction.*
*Note: If the student struggles with learning in an online environment, teachers will provide a list of potential tutors.
- Respond to students’ questions and/or concerns within 24 hours in most cases.
- Provide links to other resources outside of the Moodle platform to help students if requested or deemed necessary.
I have read through, and agree to uphold the Role of the Teacher statements.
The Role of the Parent:
*
We believe that parents are critical to the success of their student in an online environment and have an impact in promoting the students’ independence and self-development. Parents will:
-Provide the environment, technology, materials, and guidance for a successful study environment.
-Help their children develop a school work schedule that gives them ample time to complete their coursework.
-Provide an email contact to the teacher and expect emails informing them about student progress.
-Support the policies of CHEK ABC, including the activation and withdrawal policies.
-Direct any concerns about their student first to the teacher (as soon as possible) and secondly to administration.
I have read through, and agree to uphold the Role of the Parent statements.
Activation Procedures:
*
-
Students must activate each course within 45 days of the planned start date for each course.
- Students must complete ALL activation assignments to be considered fully enrolled in a course.
- Students will be given ONE calendar year in which to complete their course(s) once they have activated it. If they do not complete their course(s) within that year, they will have a choice to 1) Withdraw from the course(s) and have to start over from the beginning, take the course(s) with another school or, 2) apply for an extension and pay a $150 tuition that is used to compensate the teacher to continue with the student for up to THREE months after the one-year activation anniversary date. After the extension, if the student still has not completed the course, he/she will be withdrawn from the course(s) and have to start over from the beginning or take the course(s) elsewhere.
I have read through, and agree to uphold the Activation Procedures statements
Withdrawal Policy:
*
In some circumstances, students may need to withdraw from a course, or be withdrawn by the teacher if the student is not actively engaged. There are three scenarios here:
1) If a student
does not submit work samples in an activated course for an entire reporting period,
the teacher may withdraw the student. The student will be charged a $75 withdrawal fee and have to wait until the next term before enrolling in that course again.
2) If a student
does not activate a course
within 45 days of the anticipated start date, the student will be withdrawn and there will be a course withdrawal fee of $50 to pay for the teacher's time and administration costs.
3) Sometimes a student has to withdraw because of unforeseen circumstances. These situations will be judged on a case by case basis.
Similarly, if a student does not adhere to this contract in any way, the CHEK ABC Administration has the right to withdraw a student from a course. Students and parents will be notified in advance of the decision.
I have read through and agree to uphold the Withdrawal Policy Statements
Communication Expectations:
*
- Communicate frequently (at leaset once a week) with their teachers through his or her @chekabc.ca email, Moodle, Parent Square, phone call or work sample submission.
- Use the @chekabc.ca email exclusively to communicate with teachers.
- If applicable, advocate for their own learning needs as outlined in their IEP.
- Notify teachers if the student is unavailable for more than a week.
I have read through, and agree to uphold the Communication Expectations statements
Technology Skills:
*
- Work with the teachers to find viable ways to submit coursework in a format that is acceptable to both the student and the teacher.
- Have access to a printer and scanner for work sample submission.
- Use the Internet and all online course materials appropriately and in accordance with CHEK ABC standards and computer use policy
I have read through, and agree to uphold the Technology Skills statements
Plagiarism:
*
It is expected that all student work submitted is free pf plagiarism or cheating. Both are serious offences and result in a grade of "0" on the assignment/test. The student record will reflect the cheating has occured. A review is conducted with the teacher and principal to determine disciplinary action and may include withdrawal from the course (without refund), having to start the course again, not being allowed to enroll in another course, and/or additional assignments or replacement work assigned.
We consider plagiarism ad cheating to include (but not limited to) the following:
- Copying directly from a text, word-for-word
- Using an attractive phrase or sentence without giving reference to the author
- Using text downloaded from the Internet
- Paraphrasing the words of a text very closely
- Borrowing statistics from another source or person
- Copying from the essays or the notes of another student
- Downloading or copying pictures/photos/diagrams without listing courses
- Accessing previous tests or work from previous students in the same course
- Bringing in cheat sheets or answers to a test or supervised exam
- Having answers concealed on an electronic device during a test or supervised exam
- Texting or communicating during a test or supervised exam
- Looking at tests ahead of time
- Using the textbook during a test
- Copying or working with another student during a test
I have read through, and agree to uphold CHEK ABC's view on Plagiarism
Supervised Testing:
*
Students are required to participate in at least one supervised testing session per academic course. Each supervised test is worth a minimum of 10% of a student’s final grade. A final exam may be required to be supervised and may be worth a greater percentage of the final grade. If a supervised exam is not within 10% of a student’s course grade, then the teacher may assign a course grade based on the supervised exam results. If the teacher sees a large discrepancy between the student’s independent work and what they produce in a supervised setting, the teacher has the right to use the supervised test mark as a final grade.
Please note: At the teacher’s discretion, some students may be asked to participate in two test sessions per study term to ensure student authenticity.
I have read through, and agree to uphold the Supervised Testing statements
I have read through the policies outlined above and agree to the Course Engagement Contract.
*
Please type your full legal name to the above statement. In this instance, typed names suffice as a handwritten signature.
Student Signature
Student Signature
Student Signature
Student Signature
Student Signature
Covenant
Family Covenant
*
At CHEK ABC we believe that a successful home education occurs in partnership between home and school. We want to come along side families in a supportive way as they work towards the academic, personal, and discipleship goals of their child(ren). It is vital that parents play an important role in this partnership. The Family Covenant is an agreement that parents will join us in this process.
Please read the statements below and indicate your commitment to CHEK ABC and the schooling at home program.
1. I fully understand that I am making a commitment to educate my child(ren) at CHEK ABC
2. I will positively represent the school in my community
3. I am committed to supporting the policies of CHEK ABC
4. I will support the teachers and the administration of CHEK ABC
5. Should any concerns arise, I will direct them to the teacher as soon as possible
6. I am committed to academic integrity and will always ensure that my child(ren) complete their own work and write quizzes and tests without assistance of any kind
7. If I withdraw my child(ren) prior to September 30, I commit to cover the cost of any materials purchased by CHEK ABC and a per student withdrawal fee of $100.
I have read through each of the above statements and commit to upholding the Family Covenant so long as my family is a part of CHEK ABC.
Please type your full legal name to the above statement. In this instance, typed names suffice as a handwritten signature.
*
Attached Files
Please attach supporting documentation to your application
These documents are necessary for the enrollment process: Your child will not be considered for enrollment until we receive these documents.
- Student Birth Certificate or Passport
- Student Care Card
- Immigration documents (if applicable, please include parent's work permit and birth certificate/passport)
-
Ordinarily resident form
completed and signed
if family will be outside of BC for 6 weeks or more of the year.
- Copy of student's most recent assessment/diagnosis for learning disabilities (If applicable)
-
Records Request Form
printed and signed
Drop files here or
Select files
Accepted file types: jpg, pdf, docx, doc, Max. file size: 99 MB, Max. files: 90.
Final Step
Enrollment will be finalized when:
- All documentation has been received
- Administration has accepted placement
This is the final step in the online enrollment process. Please ensure that you have filled out the information accurately, and submitted all necessary documentation. We will contact you to confirm enrollment.
If you are not able to upload any documents at this time you can email a copy of them to
admissions@chekabc.ca
or fax them to us at (250) 352-0546.
Email
This field is for validation purposes and should be left unchanged.
