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Application for Registration Grades 10-12 Courses ONLY
If you are registering for Grades K-9 click here
This application is for the School Year 2008-09
For more information on full time programs: 250-542-0249; part-time programs: 250-549-3546

Date:

*Required Field

Student Information

Name:

 Legal Name (if different): 
 First*
First

Middle
Middle

Last*

Last

Birthdate*: Month  Day   Year  

Birthplace*:  City  Province Country  

Citizenship*:  Canadian   Other Specify  

Check if you are a permanent resident of BC? 

Gender*:  Male    Female
Medical Alerts (allergies, conditions):

 

Contact information
Street Address*
City*
Province*
Postal Code*
Home Phone*
Cell
 (e.g.250-555-5555)
Student Email address*:
 

 

Parent/Guardian Information (if you're an adult student type n/a in the Name space)
Name(s)*
Relationship to student
Address (if different)
 
Parent Email address*
Parent work number

 

Student's Aboriginal Ancestry

Check here if you are of aboriginal ancestry: 

If you checked the above question answer the following 6 questions:

 1.  Check off which apply: Status Aboriginal Non-Status Inuit Metis

 2.  Do you belong to a native band? 

             If yes what band?   What is your band number?

 3.  Do you live on a reserve?

             If yes, which Reserve
 4.  Do you have a Treaty Number? 

             If yes, what number?

 5.  Do you belong to any Metis/Inuit Associations?

 6.  How long have you lived in Vernon?

 

Educational Information

Check here if you wish to enroll full time at vLearn: (if not sure, refer back to our Registration information)

I am currently enrolled at another school
Current Grade
Name of Current or Most Recent School*   City and Province
Name of Current School Counsellor
Background Information - please indicate your reasons for registering for online courses

 

Course Request (indicate courses you would like to apply for, e.g. English 10)

Course #1 Course  #2 Course #3

When do you prefer to start the course?

 

To stop spammers we need you to type 4321 in this box. Thanks.

Submission of this form is the first step in the registration process. After this form has been received you will be sent a confirmation email from our registrar. . Your application will be reviewed and a vLearn staff member will then contact you with further information.