eLearning Student Information Form
DO: Students, complete this form, save it and email it to
DO: Emailed the form: YES ___
THIS IS NOT A REGISTRATION FORM! Sending this form to Continuing Education does
not mean you are registered for the course.
Once you have emailed the form to the
email address above, submit this form to your Guidance Counsellor.
Name of Day School:
Guidance Counsellor name:
Course code (e.g. ENG4U):
Student email address:
Student cellphone number:
Parent/Guardian email address:
Parent/guardian work number(s):
Parent/guardian cellphone number(s):