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Adult Ed Student Pre-Registration Form
ALCDSB
This form is only available for individuals who are not currently registered in a high school program.
Select a Program *
Get Your High School Diploma or Upgrade Your Courses
English As A Second Language
Literacy & Basic Skills
Personal Support Worker
Have you previously attended Loyola?
Yes
No
Personal Information
OEN (if applicable)
Legal First Name *
Legal Middle Name
Legal Last Name *
Preferred First Name
Preferred Last Name
Previous First Name
Maiden Name
Gender *
Select
Male
Female
Undisclosed
Identify Another Way
Date of Birth *
Email *
Phone Number *
Alternate Number
Address *
City *
Province *
Postal Code *
Citizenship Information
Country of Birth *
Province of Birth
Citizenship
Citizenship Status *
Select
Permanent Resident
Canadian Citizen
Refugee Claimant
Approved Refugee
CUAET
Visitor
Other
Entered From
Date of Entry to Canada *
First Language *
Emergency Contact Information
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone
Do you have any life threatening medical conditions or allergies?
Additional Information
Supporting Agency
Support Worker
Last School Board Attended
Select
Algoma DSB
Algonquin and Lakeshore Catholic DSB
Avon Maitland DSB
Bluewater DSB
Brant Haldimand Norfolk Catholic DSB
Bruce-Grey Catholic DSB
Catholic DSB of Eastern Ontario
DSB of Niagara
DSB Ontario North East
Dufferin-Peel Catholic DSB
Durham Catholic DSB
Durham DSB
Grand Erie DSB
Greater Essex County DSB
Halton Catholic DSB
Hamilton-Wentworth Catholic DSB
Hamilton-Wentworth DSB
Hastings Prince Edward DSB
Huron-Perth Catholic DSB
Huron-Superior Catholic DSB
Kawartha Pine Ridge DSB
Keewatin-Patricia DSB
Kenora Catholic DSB
Kinoomaadziwin Education Body
Lakehead DSB
Lambton Kent DSB
Limestone DSB
London District Catholic SB
Near North DSB
Niagara Catholic DSB
Nipissing-Parry Sound Catholic DSB
Non OeLC
Northeastern Catholic DSB
Other
Ottawa Catholic SB
Ottawa-Carleton DSB
Peel DSB
Peterborough, Victoria, Northumberland and Clarington Catholic SB
Rainbow DSB
Rainy River DSB
Renfrew County Catholic DSB
Renfrew County DSB
Simcoe County DSB
Simcoe Muskoka Catholic DSB
St Clair Catholic DSB
Sudbury Catholic DSB
Superior-Greenstone DSB
Thames Valley DSB
Thunder Bay Catholic DSB
Toronto Catholic DSB
Upper Canada DSB
Upper Grand DSB
Waterloo Catholic DSB
Waterloo Region DSB
Wellington Catholic DSB
Windsor-Essex Catholic DSB
York Catholic DSB
Last School Attended
Select
Last School Year Attended
OR
Last School Name
Last School City
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Phone
Language Information
Have you had an official language assessment completed?
Yes
No
Date of Assessment
What is your current Canadian Language Benchmark?
Please enter "PFL", or a number from 1-12 for each Canadian Language Benchmark field.
Canadian Language Benchmark - Listening
Select
PFL
1
2
3
4
5
6
7
8
9
10
11
12
Canadian Language Benchmark - Speaking
Select
PFL
1
2
3
4
5
6
7
8
9
10
11
12
Canadian Language Benchmark - Writing
Select
PFL
1
2
3
4
5
6
7
8
9
10
11
12
Canadian Language Benchmark - Reading
Select
PFL
1
2
3
4
5
6
7
8
9
10
11
12
Language you wish to learn?
HARTs Reference #
Select A Site
Preferred Site *
Select
Picton
Kingston
Belleville
Trenton
Belleville ESL
Kingston ESL
Selected Site Location:
Additional Files (Optional)
Assessments / Certificates
Choose File
Identification
Choose File
Download Release Of Records PDF
Release of Records
Choose File
Download Gathering Information Document PDF
Tell Us About Yourself
Why Are You Signing Up For Loyola School? *
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