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Grande Prairie Public School District STUDENT REGISTRATION FORM v5.1—

Grande Prairie Public School District #2357

Student Registration Form

STUDENT INFORMATION

Has the student attended school in Grande Prairie Public School District before? Yes No If YES, where (School): _____________________________________________ Year: _________

Has the student attended school in Alberta before? Yes No If YES, where (Town/City): __________________________________________________________________ Year: _________

Does the student have siblings attending this or another GPPSD school? Yes No If YES, sibling’s name: ___________________________________________________ Grade: _________

School Information (newsletters, attendance etc.): Yes Callouts to Phone Number __________________________________ Yes Email: __________________________________________

Independent Student Status: I Declare I am 16 or older and living on my own.

PARENT / GUARDIAN INFORMATION

Student lives with: Mother Father Guardian(s) Self Other: ___________________

MOTHER

Relation to student: __________________________________ (i.e. stepmother/grandmother, etc.)

LAST NAME: ____________________________ FIRST NAME: __________________________

ADDRESS: (if different from student): ________________________________________________

Postal Code _________________ Cell Ph: ___________________________

Home Ph: ____________________________ Work Ph: ___________________ ext______

Email: _________________________________________________________________________

FATHER

Relation to student: ____________________________________ (i.e. stepfather/grandfather, etc.)

LAST NAME: _____________________________FIRST NAME: __________________________




Email: _________________________________________________________________________

Are there any court orders affecting access to the student: Yes No (Note: Copies of Court Documents are required)

If YES, please describe: ___________________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________________________________

ENROLLING

IN GRADE:

SCHOOL ID:

GUARDIAN


LAST NAME: _________________________________ FIRST NAME: _____________________




Email: _________________________________________________________________________

GUARDIAN






Email: _________________________________________________________________________

Boundary Documentation: Yes Boundary Exemption Program of Choice

ECS: Full Day- M/W-Track A T/T-Track B Half-Day AM-Track C PM-Track D

Birth Certificate: Yes No Fees Paid:____________ Bus Eligible: Yes No P&P Teen Program

MAILING ADDRESS (Street / City)

LEGAL LAST NAME LEGAL FIRST NAME LEGAL MIDDLE NAME(S)

PREFERRED LAST NAME PREFERRED FIRST NAME DATE OF BIRTH (MM/DD/YYYY) - Copy of Birth Certificate Required

HOME PHONE ALBERTA HEALTH CARE # AGE GRADE

POSTAL CODE

PHYSICAL ADDRESS - if different from MAILING: (Street Address or Trailer/Lot or Subdivision/Lot or House #, County Address) City of Grande Prairie

County of Grande Prairie

Other

Do you live in the:

PREVIOUS SCHOOL (Complete CUM Request) PREVIOUS SCHOOL - City and Province / Country LAST GRADE COMPLETED

GENDER

CUSTODY (If applicable)

Self Worker’s Comp Youth Connections

Human Resources Worker’s Comp Band ___________

CFSA _____________ (office) Other ___________________

Course Funding: French

Immersion

OF

FIC

E U

SE

Section #_________ Teacher name:_____________________________________________

Regular

Late Entry

Male Female

Unspecified Unknown

Grande Prairie Public School District STUDENT REGISTRATION FORM v5.1—

SECTION 23 FRANCOPHONE EDUCATION ELIGIBILITY DECLARATION

(To be completed by all Parents) Citizens of Canada

Whose first language learned and still understood is French; or

Who have received their primary school instruction in Canada in French have the right to have their children receive primary and secondary instruction in French; or

Of whom any child has received or is receiving primary or secondary school instruction in French in Canada, have the right to have all their children receive primary and secondary school instruction in the same language.

In Alberta, parents can only exercise this right by enrolling their child in a French first language (Francophone) program offered by a Francophone Regional Authority.

Please put an X in the appropriate box:

A) According to the criteria above as set out in the Canadian Charter of Rights and Freedoms, are you eligible to have your child receive a French first language

(Francophone) education?

Yes No

B) Do you wish to exercise your Section 23 rights to have your child receive a French first language (Francophone) education?

Yes No

DECLARATION

I declare that all the information on this form is, to the best of my knowledge, accurate.

I agree to inform the Administration Office at the school, in writing, if any changes to this information should occur.

Signature: ____________________________________________________ Date: ______________________

STUDENT’S SPECIAL NEEDS

Describe any special educational supports or services your child currently receives or has received in the past.

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

MEDICAL CONSIDERATIONS

Medical conditions or problems the school should know about? Please describe briefly: _____________________________________________________________________________

_______________________________________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________________________________

Do you consider this a serious (life threatening) alert? Yes No

MEDICAL / EMERGENCY INFORMATION

EMERGENCY CONTACT #1 (Other than parents)

Relation to student: ___________________________________ (i.e. stepmother/grandfather, etc.)


Home Ph: ___________________________ Cell Ph: ___________________________________

Work Ph: ___________________ ext______

EMERGENCY CONTACT #2 (Other than parents)

Relation to student: ____________________________________ (i.e. stepfather/grandfather, etc.)


Home Ph: ___________________________ Cell Ph: ___________________________________

Work Ph: ___________________ ext______

(Parent/Guardian/Independent Student)

ABORIGINAL SELF IDENTIFICATION

For further information, please refer to: www.education.alberta.ca/system-supports/results-reporting or contact Alberta Education at 780-427-8501.

If you have questions regarding the collection of student information by the school board, please contact the School Board Superintendent at 780-532-4491.

If you wish to declare the student is Aboriginal, please select one:

First Nation (status) First Nation (non-status) Métis Inuit

STUDENT’S CITIZENSHIP STATUS ENGLISH AS A SECOND LANGUAGE

Is English the student’s first language spoken at home? Yes No

If NO, what is the first language spoken at home:

__________________________________________________________________

Canadian Citizen (Copy of Birth Certificate or Canadian Passport Required)

Permanent Resident

(Copy of Birth Certificate & Canadian Permanent Resident Card Required)

Temporary Resident

(Copy of Birth Certificate & Canadian Immigration Papers / Student Visa Required)

Child of Canadian Citizen

(Copy of Birth Certificate & Copy of Canadian Parent’s Birth Certificate Required)

Other (Please explain):

Form 180-1

Freedom of Information and Protection of Privacy Act (FOIP Act) Collection of Personal Information

Grande Prairie Public School District #2357 February 2017 Forms Directory

NOTIFICATION The Grande Prairie Public School District collects the personal information of students and parents (such as on the Student Registration Form) for educational purposes and to protect the safety of students and staff. As per the School Act and the FOIP Act, consent is not required to gather and share this information. Below are some examples of how and where personal information may be used. This list is not intended to be all-inclusive:

The use of student’s names, photos and comments, in the school calendar, newsletter, yearbook, graduation book, or other internal school publications;

The taking of individual, class, team, club, or school photos or videos within the school for internal school purposes;

The use of students’ name on artwork, other creative work, material of students, displayed at school or school board sites;

The use of students’ names on honour rolls, student lists, graduation ceremonies, scholarship or other awards within the school or school district.

The use of students names and academic information necessary for determining eligibility or suitability for provincial, federal or other types of awards or scholarships in the event the board applies on a student’s behalf.

The use of students’ names, related contact information and telephone numbers for absenteeism verification;

Sharing information with Alberta Education;

The sharing of students’ names, addresses, grades, age, contact information and telephone numbers with Alberta Health Services.

In accordance with the Freedom of Information and Protection of Privacy (FOIP) Act, Grande Prairie Public School District is authorized and required under the provisions of the School Act and its regulations to collect, use and disclose personal information necessary to provide an educational program and ensure a safe and secure school environment for students. Grande Prairie Public School uses Google Apps for Education allowing all students and staff to communicate and collaborate. Any emails, documents, presentations or files created in Google Apps for Education is stored on servers located outside of Canada and subject to foreign laws. Please note: photos or videos of students attending or participating in school activities (e.g., sports events, concerts, cultural programs, clubs, field trips, graduation or other ceremonies) that are open to the general public may be taken by the public-at-large, including the media, without consent. Grande Prairie Public School District cannot control or prevent the further distribution or use of these photos, videos, images or other personal information. When student information is used by the school or the school district for purposes beyond educational programming and student safety, the FOIP Consent must be signed and returned to the school. Please contact the school principal if you have any questions or concerns regarding the collection or intended uses of this information.

Form 180-1

Freedom of Information and Protection of Privacy Act (FOIP Act)

Grande Prairie Public School District #2357 July 2017 Forms Directory

Student Name: ________________________ Parent Name: _______________________

Applicable School Year: _________________

FOIP CONSENT Consent to Post or Publish Student Information

The Grande Prairie Public School District #2357 is requesting your permission to use your child’s personal information (i.e., photograph, grade and/or name, etc.) in public venues, on the Internet, or in publications where the general public may have access to the information in order to communicate with parents, the community and the general public. By signing this form, you are agreeing that your child’s personal information may be used in the following ways by the school and school district. Examples include, but are not limited to:

video recordings;

displays;

posting pictures, videos, podcasts or presentations online;

external publications such as brochures, program booklets, or newsletters; and

accessing and posting information to public websites or social media applications (e.g., Facebook, Picasa, Flickr, YouTube, Twitter and other emerging technologies.

.There may also be occasions where photos are taken of students at school sponsored activities by media or staff, for publication, where students are not identified by name, such as: photographs or videos of students on the playground, taking part in music or sporting events or simply watching an event, etc.

Yes, I consent to my child’s information being used for the above stated purposes:

***_______________________________________________ (Parent/guardian signature)

If non-GPPSD media wishes to identify your child by name, consent will be acquired before the picture or article is published.

COPYRIGHT CONSENT The federal Copyright Act requires that permission from the copyright owner, in this case the student, be obtained from the student’s parent to use or reproduce the schoolwork (e.g. artwork, essays, poems) in this way. For example, the school may want to display student artwork at community events or on the school’s web page, or submit schoolwork to Alberta Education. Displaying the work would be considered a “public performance” of the work under the Copyright Act.

I grant permission to the Grande Prairie Public School District #2357 to use my child’s work for non-profit educational purposes as outlined above:

***______________________________________________________ (Parent/guardian signature)

Signed this _________ day of __________, 20___, on behalf of ____________________________

(Student’s name)

By signing this form and returning it to the school, you are consenting to your child’s information being used for these purposes. If no form is returned, it indicates that consent was NOT given. If you have any questions or concerns regarding the collection of this information and the intended purposes, please contact the Principal at your school, or the FOIP Coordinator for the Grande Prairie Public School District #2357 at 780-532-4491.

Form 149-1

Grande Prairie Public School District #2357 January, 2018

Forms Directory

Grande Prairie Public School District #2357 10127 120 Avenue

Grande Prairie, AB T8V 8H8 Ph: 780-532-4491

Fax: 780-539-4265

Electronic Communications Consent Form

We want to continue to keep you up-to-date and informed about the latest school and school board information, events, and announcements through electronic communications such as emails, texts, phone messages, newsletters, and social networking sites from Grande Prairie Public School District (GPPSD), its schools, school councils and the GPPSD Education Foundation. Occasionally these communications may include information about offers, advertisements or promotions related to school activities such as school fees, yearbooks, school clothing, field trip opportunities, student photos, fundraising events or similar school related activities.

Canada’s new Anti-Spam Legislation came into effect July 1, 2014. Without your consent we may be unable to send you these types of communications electronically.

To receive these communications, please indicate your consent below.

Please note that if you do not respond, we may be unable to continue to send you electronic communications.

If you have any questions, or wish to withdraw your consent at any time, please contact the school or Central Office at 780-532-4491.

___________________________________________ Student Name

___________________________________________ School

___________________________________________ Parent/Guardian Name

___________________________________________ Parent/Guardian Signature

___________________________________________ Date

I consent to GPPSD, its schools, school councils and the Education Foundation to send commercial electronic messages (CEMs)

I DO NOT consent to GPPSD, its schools, school councils and the Education Foundation to send commercial electronic messages (CEMs)

10127 120 Avenue

Grande Prairie, Alberta

T8V 8H8

(780) 532-4491 Phone

(780) 539-4265 Fax

March 1, 2018

Attention: All Parents of Grande Prairie Public School District students

Re: Aboriginal Data Collection Initiative

Tansi! Parent(s) and Guardian(s),

As you register your child (children) for the school year, please take the time to look at the Aboriginal Self-

Identification question on the form. If you or your child (children) identify as First Nations, Métis, Non-Status

or Inuit, you can identify under the Alberta Education Aboriginal Data Collection Initiative. Please note, you do

not need to have a treaty or Métis card to self-identify. Self-declaration is voluntary and is collected pursuant

to Section 33 of the Freedom of Information and Protection of Privacy Act and will be kept strictly confidential.

In self-identifying your child (children) this information is then used as part of the funding calculation for our

District. The funding is then allocated to the District FNMI Program, which houses the FNMI Program Team for

our schools as well as, allows us to develop culturally appropriate professional development for our

Administration, teachers and staff, along with cultural activities and other supports for our students at the school

and district level.

If you have any questions regarding the Aboriginal Data Collection Initiative, please feel free to contact me.

In Friendship,

James Robinson

Assistant Superintendent – Programs & Planning

(780) 532-4491

Form 140-1

Grande Prairie Public School District #2357 Student Responsible Use of Technology Guidelines and Agreement

Grande Prairie Public School District #2357 February 2018 Forms Directory Page 1 of 4

SECTION A: GENERAL USE OF TECHNOLOGY

As a student of Grande Prairie Public School District, I value having access to technology to support my learning. I know that along with this privilege comes great responsibility. To demonstrate my commitment and understanding of the level of responsibility that is required, I have read each of the expectations and guidelines listed below. I will abide by the responsibilities and expectations laid out for the use of electronic/computer devices (a computing device includes but is not limited to the following that is used by the student: laptop computer, netbook, Chromebook, iPad, eReader, iPhone – or other devices with internet access, e.g. BlackBerry, cell phone, iPod Touch, PDA, game system, etc.)

• I understand that having access to technology in school is a privilege. I understand that this privilege may be revoked if I fail to fulfill my responsibilities as a user of this technology and that many, but not all, of these responsibilities are outlined below.

• I will only use technology for educational purposes while in school, unless I have been granted permission by a teacher or staff member; and then I will only use the technology within the parameters or guidelines established by them.

• When connected to the internet, I will never use my electronic/computer device to reveal personal information such as my age, address, or phone number, or those of other students for persons.

• I understand that Grande Prairie Public School District uses a content filter on its internet access, yet I know it is possible that I may encounter inappropriate material, which includes images or text that are pornographic, violent, obscene, or offensive to others. I will immediately close the window on the screen that depicts this material. I will then inform my teacher.

• I understand that my personal files and information about every webpage I visit may be accessible under the provisions of FOIP. I am aware that an individual search may be conducted if there is reasonable belief that I have violated the law or the District’s Student Responsible Use of Technology Guidelines and Agreement.

• I understand that my actions using electronic/computer devices and accessing the internet reflect on me, my class, and the school. I will conduct myself accordingly and exercise good judgement.

• I will not download or install any software, music, movies, or files of any nature unless I have been granted specific permission to do so by my teacher and the copyright holder grants permission.

• I will not share my Student Network Login password or any other usernames and passwords provided by Grande Prairie Public School District personnel with anyone except my parents or legal guardians.

• I will always log out of the computer and any applications when I have finished using them, or when moving out of sight of the computer. I acknowledge that any actions done on a computer when I am logged in are traceable to me.

• I will not create, use, display, or store any offensive, obscene, inflammatory or defamatory language or images. I

will not use the technology in any way that negatively affects any other student or person.

SECTION B: USE OF PERSONAL COMPUTING DEVICES AT SCHOOL

As new technologies continue to change the world in which we live, they also provide many new and positive educational benefits for classroom instruction. To encourage this growth, students at Grande Prairie Public School District may bring their own technology to school.

Students at this school may bring their own personal electronic/computing devices which may be able to connect to the school’s wireless network. Privately owned wireless and/or portable electronic handheld equipment that includes, but is not limited to, existing and emerging mobile communications systems and smart technologies, portable internet devices, Personal Digital Assistants (PDAs,) handheld entertainment systems or portable information technology systems, that can be used for word processing, wireless internet access, image capture/recording, sound recording and information transmitting/receiving/storing, etc. When using student-owned, personal computing devices at school, all of the General Use of Technology Guidelines (Section A) apply as well as the following:

• I will connect to the school’s wireless network, and NOT to the school’s wired network, or any visible network from the neighbourhood. The guidelines below apply regardless of the wireless network used.

• In class, I will use the student owned device only with the teacher’s expressed permission.

• The device I am using will have virus protection software which is up-to-date.

Form 140-1



• I will turn off all peer-to-peer (music/video/file-sharing) software or webhosting services on my device while connected to the school’s wireless network.

• I understand the security, care and maintenance of my device is my responsibility. I will securely store my device when not in use.

• I understand that the school is not responsible for the loss, theft, or damage of my device. I am fully responsible for my property while it is at school.

• I understand that personnel from Grande Prairie Public School District may access my personal electronic/computing device if there are reasonable grounds to believe that there has been a breach of school rules or discipline policies and that a search of the device would reveal evidence of that breach. This may include, but is not limited to, audio and video recording, photographs taken on school property that violates the privacy of others, issues regarding bullying, etc.

(A personal computing device includes, but is not limited to, the following that is owned by the student: laptop computer, netbook, Chromebook, iPad, eReader, iPhone - or other devices with internet access, e.g. BlackBerry, cell phone, iPod Touch, PDA, game system, etc.)

SECTION C: USE OF CLOUD BASED APPLICATIONS AND GOOGLE APPS FOR EDUCATION

Students at this school have access to Cloud Based Applications and Google Apps for Education services (email, online documents, calendar, video, etc.) for educational purposes. Cloud Based Apps and Google Apps accounts and services are managed by school personnel. Student files (e.g. essays, presentations, email, etc.) are stored on cloud servers which are located in various countries including the United States of America. Contents will be subject to the law of the jurisdiction. For example, Grande Prairie Public School District cannot guarantee protection against possible disclosure of emails residing in the United States of America. Therefore individuals should make informed decisions about what kind of information they wish to transmit.

All of the General Use of Technology Guidelines (Section A) apply when accessing resources through Cloud Based Applications and Google Apps for Education Accounts, as well as the following:

• I understand that my first two initials of my first name, along with my last name, will be used by Grande Prairie Public School District to create a Google Apps Account. I will be given rights to access this account.

• I will be provided with an email address (e.g. [email protected]) to use for school purposes. This address is what gives me secured access to my online file storage, documents and sites.

• I understand that personnel from Grande Prairie Public School District may access my Cloud Based Apps or Google Apps accounts if there are reasonable grounds to believe that there has been a breach of school rules or discipline policies and that a search of the account would reveal evidence of that breach. This may include, but is not limited to, email messages, gadgets, archived chats, docs, sites, photographs, uploaded documents, etc.

• I understand that my parents or legal guardians also have access to my Cloud Based Apps and Google Apps account, including email, docs and sites. I can either log in and give them a tour of my files, emails and sites, or the school personnel can share my logon ID and password with my parents or legal guardians.

STUDENT ACCEPTABLE USE OF TECHNOLOGY GUIDELINES AND AGREEMENT FOR HIGH SCHOOL STUDENTS:

If the form has been previously signed while your child consecutively attended another GPPSD school, by not signing this form you are granting your permission for your child to use the Cloud based applications and Google applications for education. If you wish your child not to have access to the District’s system or use of devices as outlined in this document, please indicate so on the form and return.

Form 140-1



STUDENT ACCEPTABLE USE OF TECHNOLOGY GUIDELINES AND AGREEMENT (GRADES 4 – 12)

Student Name: ______________________________________

School: _________________________________

Grade: _______

STUDENT SECTION


I have read the Acceptable Use of Technology Guidelines and Agreement. I agree to follow the expectations contained in these guidelines. I understand that if I violate the agreement, my account can be terminated and I may face other disciplinary measures.

I Agree I Disagree


I have read the Acceptable Use of Technology Guidelines and Agreement for the use of personal computing devices at school. I accept all responsibility when bringing my own personal computing device(s) to school.

I Agree I Disagree


I have read the Acceptable Use of Technology Guidelines and Agreement for the use of Cloud Based Applications and having an email address and using a Google Apps for Educations account. I accept all responsibility for using my Google Apps for Education account and email address as set forth in this document.

I Agree I Disagree

Student Signature: _____________________________ Date: _______________________

Form 140-1



PARENT ENDORSEMENT (GRADES 4-12)

I have reviewed this document and each paragraph with my child. I have discussed the importance of this agreement with my child.

Student Name: ______________________________________

School: ____________________________________________ Grade: _______


I understand that computer access is for educational purposes. I will instruct my child regarding acceptable use, including that which is set forth in the Acceptable use of Technology Guidelines Agreement. I will emphasize to my child the importance of following the rules for personal safety.

I give permission to allow internet access for my child and certify that the information contained in this form is correct.

I DO NOT give permission to allow internet access for my child.


My child understands the expectations and responsibilities associated with using a personal computing device at school as well as the appropriate and ethical use of the technology.

I give permission to allow my child to bring his/her personal computing device to school for educational use.

I DO NOT give permission to allow my child to being his/her personal computing device to school.


My child understands the expectations and responsibilities associated with using Cloud Based Applications and having an email address and using a Google Apps for Education account.

I give permission to allow my child to have an email address issued by Grande Prairie Public School District.

I DO NOT give permission to allow my child to have an email address issued by Grande Prairie Public School District.

By signing below, I hereby release Grande Prairie Public School District and its personnel from any and all claims and damages arising from my child’s use of, or inability to use: the Grande Prairie Public School District computer systems; their personal wireless device on the school’s wireless network; and Cloud Based Applications and the Google Apps for Education Account.

Parent/Guardian Name: ________________________________ Date: _________________________

Parent/Guardian Signature: _____________________________ Phone: ________________________

Form 320-5

Grande Prairie Public School District #2357 August 2017Forms Directory

Grande Prairie Public School District #2357 10127 120 Avenue

Grande Prairie, AB T8V 8H8Phone: 780.532.4491

Fax: 780.539.4265

STUDENT CUMULATIVE RECORD REQUEST PARENT CONSENT FORM

Student: ________________________________ Grade: __________________

Date of Birth: _____________________________ AB Ed# __________________

School Last Attended: _________________________________________________

Please be advised that the above student is now attending:

_________________________________________________ (GPPSD School Name)

Date Entered GPPSD: ______________________________

Please forward to us the student file and any other pertinent information you may have. Thank you for your assistance.

Thank you,

Grande Prairie Public School District #2357

CERTIFIED PARENTAL NOTIFICATION

I, the undersigned parent/guardian, certify that I am aware of the above request and that I approve such transfer of the records:

_____________________________ ________________________________ Parent/Guardian Signature Date

The information on this form is being collected in accordance with the Freedom of Information and Protection of Privacy Act, under the authority of The School Act, and Grande Prairie Public School District policies and procedures. If you have any questions about the collection, use, or disclosure of this information, please contact the Grande Prairie Public School District FOIP Coordinator at 780-532-4491.

GPPSD School Address: (stamp)