STUDENT APPLICATION FORM Application Deadlines Program Space

student application form ======================== application deadlines --------------------- program space is limited. pleas

STUDENT APPLICATION FORM
========================
Application Deadlines
---------------------
Program space is limited. Please apply early.
Term starting September – All grades (kindergarten to grade 12) –
Deadline: May 31
Term starting February – Grades 9 to grade 12 – Deadline: November 30
Complete all pages of this form: PRINT CAREFULLY in ENGLISH
Date of Application: ______________________________________
year/month/day
Tell Us About Yourself
----------------------
Student Surname
_______________________________________________________________
family name
Given Name: _____________________________________ English Name
______________________________________
(if applicable)
Gender: Male  Female  Date of Birth:
__________________________________
year/month/day
Country of Birth ___________________________________ Citizenship
___________________________________
First language: ______________________________________
Address in Home Country:
_________________________________________________________________________
City: ___________________________________________ State/Province:
________________________________
Country: ________________________________________ Postal Code:
__________________________________
Telephone Number ________________________________ Fax Number:
__________________________________
Student E-mail Address: ____________________________
Parents
-------
Father
Surname ________________________________________ Given name:
__________________________________
Telephone (work)__________________________________ E-mail Address
________________________________
Mother
Surname ________________________________________ Given Name:
__________________________________
Telephone (work)__________________________________ E-mail Address
________________________________
School Record
-------------
Attach original or certified copies of transcripts or school records
from the previous 2 years of study (translated into English)
Name of your current school: ________________________ Location:
_____________________________________
Last grade completed: _____________________________ Number of years in
your current school: _____________
Month your school year begins ______________________ Month your school
year ends______________________
I Am Applying For
-----------------
*The Ottawa-Carleton District School Board may assign you to a school
based on where you will be living and available space in schools. The
Board also reserves the right to determine your grade. Please visit
our web site at www.ocdsb.ca for a list and description of elementary
and high schools.
Applying for grade _________
How long: ❑ 1 semester (5 months) ❑ 2 semesters (10 months) ❑ Or
_________ months
High school (grades 9 to 12) (choose one) 1. First term starting
September 
2. Second term starting February 
Elementary school (junior kindergarten to grade 8) 1. Terms starts
September 
2. Start date if not September _____________________
Do you wish to attend a particular school* in Ottawa? Yes 
________________________No preference 
Speaking and Learning English
-----------------------------
*All students must be assessed for math and English skills before
entering school.
How many years have you taken formal English classes?
In school: 1 yr  2 yrs  3 yrs  4 yrs  more 
Private lessons: 1 yr  2 yrs  3 yrs  4 yrs  more 
Please indicate your level of English: Beginner  Intermediate 
Advanced 
Young People’s Language School
------------------------------
Do you need help with English? Come to Ottawa early and attend Young
People’s Language School.
Young People’s Language School (www.ypls.ca) offers intensive English
classes and an orientation program for students planning to attend
high school in Canada. Students can come all year-round for 8-week
intensive sessions to improve their English and for a 2-week
orientation in August with English lessons and activities to discover
their new environment.
If you are interested in the intensive classes or the orientation
program, please choose the session(s) you are applying for: 
September – October  November – December  January – February  March
– April
 May – June  July – August  2-week Orientation in August
Do you need support during the school year? Young People’s Language
School has an After-school program. The After-school Program provides
homework help and group tutoring on 3 days per week from September to
June.
Are you interested in the After-school program?  Yes  No
My Interests and Objectives
---------------------------
I want to:  Improve my English skills and take courses assigned to me
by the school.
 Improve my English and take the following specific courses for
credit.
________________________________________________________________________________
 Graduate with an Ontario High School Diploma
My favourite subjects:
_____________________________________________________________________________
My favourite sports:
_______________________________________________________________________________
My hobbies:
_____________________________________________________________________________________
Accommodation and Care
----------------------
All international students must live with a family while studying in
the Ottawa-Carleton District School Board.
1. Do you require homestay arrangements? Yes ___ No ___
2. If YES, please complete and submit a homestay application form
(available at www.ocdsb.ca/oisp).
Custodians
Students under the age of 18 must be supervised by an adult custodian
living in Ottawa. Custodians must be a parent or a citizen/permanent
resident of Canada. You must submit notarized custodianship papers to
Citizenship and Immigration Canada and the international student
program office. Canada Homestay International (CHI) manages custodian
and homestay arrangements for students in its homestay program.
Do you require a custodian arrangement? Yes ___ No ____
If you have a family to live with and a custodian, please provide
their information below.
Ottawa home address
Family’s surname: ________________________________ First name:
___________________________________
Relationship to student _____________________________ E-mail address:
________________________________
Street address:
__________________________________________________________________________________
City: OTTAWA Province: ONTARIO Country: CANADA Postal code:
________________
______________________ ________________________
_______________________ _______________________
home telephone work telephone cell phone fax number
Custodian’s Information (if different from above)
Surname: _______________________________________ First Name:
___________________________________
Relationship to student _____________________________ E-mail Address:
________________________________
Street address:
__________________________________________________________________________________
City: OTTAWA Province: ONTARIO Country: CANADA Postal code:
________________
______________________ ________________________
_______________________ _______________________
home telephone work telephone cell phone fax number
Your health
-----------
An up-to-date immunization record is required by the Ottawa Public
Health Department and school officials. A form outlining immunizations
requirements will be sent to all students accepted to the
international program.
Does the student have any medical condition / or take any medication?
Yes ___ No _____
If YES, please describe:
___________________________________________________________________________
_______________________________________________________________________________________________
Does the student have a perceived or documented learning disability,
physical handicap, social integration difficulty, behavioural concern
or history of criminal behaviour? Yes ___ No _____
If YES, please describe:
___________________________________________________________________________
_______________________________________________________________________________________________
Agent information
-----------------
Please indicate your status: OCDSB/OISP representative  New agent 
Name of agency:
_________________________________________________________________________________
Street address:
_________________________________________________________________________________
________________________ __________________________
_______________________ ___________________
city state/province country postal/zip code
__________________________ __________________________
__________________________
work telephone cell phone fax number
Permission to release information
---------------------------------
This section must be filled out to authorize the agent to receive
personal information about the student.
I authorize __________________________to receive personal, school and
homestay information electronically
Name of Agent
of ______________________________ on my behalf.
Name of Student
________________________________________________
_____________________________________________
Name of Mother Signature of Mother
________________________________________________
_____________________________________________
Name of Father Signature of Father
Student Participation Agreement
-------------------------------
The Ottawa-Carleton District School Board is committed to providing
the best possible educational environment for its students. For the
health, welfare and academic well-being of students, all students must
follow the rules and guidelines below:
As an international student you will:
*
live with a local family
*
obey the laws of Canada and the rules and customs of the school in
which you are enrolled
*
contact the Ottawa International Student Program office and your
school if you move
*
attend school on a daily basis
*
obey teachers and follow reasonable rules established by host
parents
*
follow the rules and guidelines of the Ottawa International
Student Programs
You must also:
*
make determined efforts in your school work
*
maintain a full-time timetable (high school students must take a
minimum of 3 courses per semester in a semestered school and 7 in
a non-semestered school)
*
complete all homework and assignments
*
maintain at least a “C” or 65% grade point average
*
participate in a school sport or club activity
*
permit the school to share the contents of school attendance and
academic reports with your parents, custodian/guardian, the Ottawa
International Student Programs office, agent and host parents in
order that guidance and assistance can be provided as required
Any continuous failure to abide by the above guidelines may result in
dismissal from school and the Ottawa-Carleton District School Board.
Students dismissed from the Ottawa International Student Programs may
be sent home at his/her own expense without refund of fees.
I have read, understand and agree to follow I have read, understand
and agree to the rules
the rules and guidelines as outlined above. and guidelines as outlined
above.
_______________________________________
________________________________________
Name of Student (PRINT) Signature of Mother
________________________________________
Signature of Father
Terms and Conditions
--------------------
*
Ottawa-Carleton District School Board (OCDSB) is not liable for
losses/expenses that may incur as a result of the District being
unable to provide education owing to labour disputes, inclement
weather conditions or other causes beyond its control.
*
Canada and Ottawa are very safe by world standards. While the
student will be generally supervised, such supervision can not be
constant and the OCDSB cannot guarantee the student’s safety.
Therefore, should the student be injured while studying in Canada,
the OCDSB will not be held liable.
*
If the student’s educational needs are greater than disclosed on
the application, the OCDSB reserves the right to charge for extra
support if such support is available.
*
Any inaccuracy in the application is grounds for the OCDSB to
terminate the agreement and send the student home without refund
and at the parent’s own expense.
*
The Ottawa-Carleton District School Board, its officers,
employees, agents, volunteers and representatives will not be held
responsible for any injury loss or injury suffered by the
applicant during periods of travel and study. If the applicant
becomes ill or incapacitated, the OCDSB and its representatives
may take such action as it considers necessary, including securing
medical treatment and transporting the applicant home at his/her
expense.
*
The undersigned hereby agrees to indemnify the OISP and OCDSB for
damages or expenses incurred, resulting from our child’s wilful or
negligent behaviour or actions.
I have read and understand the student participation agreement, terms,
conditions and refund policy and verify that everything stated in the
application is true and can be relied upon by the Board in offering a
place to the student in the International Program.
I also understand that my signature gives permission for:
*
My child to participate on any field trip arranged by the
Ottawa-Carleton District School Board or OISP within Canada.
*
The Ottawa-Carleton District School Board to use photographs of my
child and/or artwork and/or written work produced by my child in
any promotional material and/or professional media for the Ottawa
International Student Programs.
Mother’s Name (print) ______________________________ Mother’s
Signature ______________________________
Father’s Name (print) ______________________________ Father’s
Signature _______________________________
How to Apply for the Ottawa International Student Program
---------------------------------------------------------
Step 1: Application
Submit the following to: Ottawa International Student Program (OISP)
Ottawa-Carleton Education Network Inc.
440 Albert Street, Room C315
Ottawa, Ontario, Canada K1R 5B5
*
A completed application form signed by the student and parent(s)
*
Official copies of school report cards for the past 2 years
*
Current year’s school report card
*
Certified translated copies of school report cards
*
One passport size photograph
*
Letter of recommendation from a teacher or school principal (use
form provided)
*
Photocopy of student’s passport or birth certificate
*
$200 non-refundable application fee.
If homestay is required, also submit the following:
*
$350 homestay placement and administration fee
*
$450 custodianship fee
*
Homestay application form
*
Homestay consent and release form
Step 2: Acceptance Letter
You will receive an initial acceptance letter within two weeks if all
documentation is in order. The acceptance package will also include
Custodianship forms (if applicable).
Step 3: Fees
Send the full tuition fee, medical fee, homestay fees, homestay
deposit, airport transfer fees and a notarized custodianship document
to the Ottawa International Student Program office.
Step 4: Study Permit
Student receives a final letter of acceptance and applies at the
nearest embassy, Canadian Consulate, or High Commission for a Study
Permit. Approval may take 6-20 weeks. (Please contact the nearest
Canadian Immigration office for detailed information on application
processing times in your country.)
Step 5: Orientation and Assessment
At least one month before school starts contact international student
program office to make an appointment for the student’s English
language and mathematics assessment.
Step 6: School Entry
After the student’s assessment has been evaluated the student’s
custodian/parent will be contacted with a day and time to report to
school. High school students will select their courses at this time.
Payment Process
---------------
All fees may be paid by international money order, bank draft, or
certified cheque and made payable to the Ottawa-Carleton Education
Network. Fees may also be paid by direct wire transfer to the Ottawa
-Carleton Education Network bank account:
SCOTIABANK /The bank of Nova Scotia
Account # 00166 01160 17
Transit #47886
Toronto Business Support Centre
40 King Street West
Toronto, Ontario
Canada
Account Name: Ottawa Carleton Education Network Inc .
Swift Code: NOSCCATT
ABA Number: 026002532
NOTE: Please add $20CDN to tuition fee if paying by wire transfer.
Application fees for school ($200), custodianship ($450), homestay
($350), and YPLS ($125) if applicable may be paid by Mastercard or VISA.
I learned about the Ottawa-Carleton District School Board from:
Friend or relative  Education fair  Government office 
Advertisement 
Canadian Education Centre (CEC) office  Agent
____________________________________________________
Web site
Internet search 
OCENET web site www.ocenet.ca 
OISP site www.ocdsb.ca/oisp 
Other ________________________________________________________
ACKNOWLEDGEMENT
The personal information on this form is gathered under the authority
of the Education Act, Immunization of School Pupils Act and Personal
Health Information Protection Act and will be used by the school and
central administrative staff to provide a broad range of academic,
health and administrative services. Anyone having the right, may
access this information by contacting the Ottawa-Carleton Education
Network (OCENET). Please keep OCENET advised of any changes in the
above information as soon as possible.