School With-in A College

(SWAC)

Application/Interview Booklet

Application for Feb 2018 to June 2018

Semester 2 Intake

SWAC Application and Interview Booklet

Table of Contents:

Title Page 1 Table of Contents 2 Application/Interview Procedures 3 SWAC Application/TVALT Registration 4 College Consent Form 5 TVDSB SWAC Student Expectations 6 TVDSB Dual Credit Transportation/Attendance Letter 7 TVDSD Field Trip Form 8 TVDSB Media Consent Form 9 Consent to Disclosure Form 10 SWAC Reference Letter 11 Application Checklist 12

SWAC Application/Interview Information SWAC Application Information:

Applications are found on the board website www.tvdsb.ca/Programs. On left, click on Dual Credit/SWAC/SWAU Programs, choose the SWAC program you are interested in (you have two choices, Fanshawe SWAC or Lambton SWAC). Fanshawe London, St Thomas, Woodstock and FNMI are located under Fanshawe College SWAC.

The application is designed so you can type the information into fields. Handwritten applications unfortunately cannot be accepted.

SWAC Interview Information:

SWAC teachers will organize and communicate specific interview dates and times for each school.

Students will be interviewed starting late Nov 2017 Jan 2018

Student’s off-roll will be interviewed at the Fanshawe campus. Please forward any names of students who are off-roll that may benefit from the SWAC program.

Student’s on-roll will be interviewed at their home school. We would ask that a member of the Student Success Team collate names of interested students and organize a schedule for interested candidates in conjunction with SWAC teacher(s), as well as arrange a location for interviews to take place.

We ask interested students to bring their completed application package, credit counselling summary and an IEP (if applicable) to the interview.

Contact information for each SWAC Site: Fanshawe London: Andrea Ross Matthew Harris a.ross@tvdsb.ca matthew.harris@tvdsb.ca 519-619-8378 519-852-5341 Fanshawe Woodstock: Sean Mattys s.mattys@tvdsb.ca 519-200-9731 Fanshawe St Thomas: Keith Avery k.avery@tvdsb.ca 519-619-9269 Fanshawe London-FNMI: Lauren McLaughlin lauren.mclaughlin@tvdsb.ca 519-649-8771

SWAC Application/TVALT Registration Form

OEN Referring Home School Legal Last Name Legal First Name Middle Initial Preferred Last Name Preferred First Name Birthdate Gender Home Address City Postal Code Email Address Home Phone Cellphone Allergies/Medical Concerns

Emergency Contact Last Name First Name Relationship Home Phone Cellphone Work Phone Parent/Guardian Information (required if under 18) Last Name First Name Relationship

Address City Postal Code Home Phone Cellphone Work Phone ___________________________________________________ __________________ SWAC Applicant Signature Date ___________________________________________________ __________________ Home School Guidance Counsellor Signature Date ___________________________________________________ __________________ Home School Administration Signature Date

To be completed by Thames Valley Alternative School Staff ____________________________________________________ __________________ ______ SWAC Program OSSD Course Block ___________________________________________________ __________________ SWAC Teacher Signature Date

Freedom of Information and Protection of Privacy Act (Mandatory)

Fanshawe College adheres to the Freedom of Information and Protection of Privacy Act. The information collected by Fanshawe College is collected under the legal authority of the Ontario Colleges of Applied Arts and Technology Act, 2002, Ontario Regulation 34/03. The information is used for administrative, statistical and safety and security purposes of the college and/or the ministries and agencies of the Government of Ontario and the Government of Canada. Fanshawe College is required to disclose personal information such as Ontario Education Numbers, student characteristics and educational outcomes to the Minister of Training, Colleges and Universities under s. 15 of the Ministry of Training, Colleges and Universities Act, R.S.O. 1990, Chapter M. 19 as amended. The ministry collects this data for purposes such as planning, allocating and administering public funding to colleges, universities and other post-secondary educational and training institutions and to conduct research and analysis, including longitudinal studies, and statistical activities conducted by or on behalf of the ministry for purposes that relate to post-secondary education and training. Further information on how the Minister of Training, Colleges and Universities uses this personal information is available on the ministry's website. I give consent to Fanshawe College, my home school, and my school board to release my application, academic information and any other information relating to my dual credit course between Fanshawe College and the School Board. I am aware that if I have an Individual Education Plan (IEP) that this information may be shared by the school board's Dual Credit Teacher with Fanshawe College SCWI Staff to determine appropriate accommodations. I am aware that upon admission to the Dual Credit program, basic student information will be permanently retained by the College in an electronic format. I give my consent for the student named in this application to be transported by Fanshawe College and will assume all liability for my/their participation in this dual credit course and any injury that may result during the transport or at the college. I also understand that some courses may involve field trips that take students off the college campus.

□ I understand and agree to the above statement from Fanshawe □ I do not comply with the above statement

To be signed by student AND guardian if student is under eighteen (18) years of age:

__________________________________ __________________________________ ____________

Student Name (please print) Signature Date

__________________________________ __________________________________ ____________

Parent/Guardian Name (student under 18) Signature Date

(SWAC) Student Expectations You are interested in applying to the School within a College (SWAC) Program. Great Decision! Please read the information outlined below. Please review the expectations below and sign that you have read and are in agreement with the following.

THAMES VALLEY ALTERNATIVE EDUCATION SCHOOL EXPECTATIONS:

Attend school regularly; Maintain marks representative of your ability; Submit all assignments on time; You must demonstrate successful progression in your OSSD courses. Refrain from using all forms or social media and electronic entertainment while in the classroom

No “alternate plans” in regards to transportation. You must travel to and from the College on the buses and/or

cabs provided for you; Pickup and return locations must be the same location. Failure to comply with this policy may result in removal from the SWAC Program

COLLEGE EXPECTATIONS:

Appropriate conduct that portrays a positive image upon yourself, your classmates and the Thames Valley District School Board.

Behavior and maturity consistent with an adult-oriented community college learning environment; Attendance: attendance is critical to achieving success in a community college environment. Inconsistent

attendance will result in a failure to achieve the expectations as outlined for a dual credit course and a permanent failing grade on a college transcript.

You must meet the expectations of any dual credit course as outlined by the college instructor. This may include, but not be limited to, attending field trips or reach ahead activities as part of the School College to Work program expectations;

IMPORTANT FACTS: You must meet the expectations of the college course in order to be granted the high-school credit. In

some college courses a pass may be over 60%. Course expectations are determined by the college professor.

Practical courses require good attendance and being prepared each day to participate in the learning environment. Items such as books, pens, pencils, and personal protective equipment (PPE) are required each day.

Colleges do not shut down for P.A. days. Your attendance at the college on scheduled P.A. days may be required

VERY IMPORTANT FACT: ***You must be an active participant in the Dual Credit program in order to remain registered in the

School Within A College program(SWAC)*** Date: ___________________ Student Name (print) _______________________

Student Name (signature) _______________________ Parent Signature _________________________________ (Required if student is under 18years of age)

May 2017

Dual Credit Transportation/Attendance Letter

To Whom It May Concern:

The purpose of this letter is to outline attendance and transportation expectations for those students participating in a Dual Credit

program. The program permits students to reach ahead to the next level of their educational path. However, it does bring challenges

and expectations that are different from high school.

Attendance is a critical component of the program to ensure success. It is imperative that students attend 100% of their college

classes. We strongly encourage parents and students review their home calendar in regard to appointments, sporting events or holidays

arranged on dual credit days. In some courses a missed class could jeopardize the student’s chance of success.

Students should not EXPECT college professors to change or alter due dates and course expectations to accommodate personal

commitments. It is very important that students avoid booking any appointments on Dual Credit days. Multiple absences could result

in removal from the Dual Credit program regardless of their academic progress in the college course.

Transportation is a large component of the Dual Credit program. The supervision and security of students is very important to

Thames Valley District School Board. The program provides transportation to all students in a variety of ways. Students living within

the city where the college courses are being offered are provided bus tickets. Students participating in college courses outside of their

city are provided transportation by means of bus, van or taxi and are held to very strict guidelines.

TVDSB does not permit “alternate plans” in regards to the transportation of your child. You must travel to and from the college on

the busses and/or cabs provided for you; Pickup and return locations must be the same location. Failure to comply with this policy

may result in removal from the Dual Credit Program.

Parents and guardians need to be aware that students transported within the Fanshawe Dual Credit program will not be supervised, it

is an expectation that student behavior be reflective of the Thames Valley District School Board and Southwestern Ontario Student

Transportation Services policy. Students transported to the Lambton College or Conestoga College (Doon Campus) will have a bus

supervisor to help ensure student behavior is appropriate.

Students that fail to meet the behavior and attendance expectations MAY be removed from Dual Credit Program.

“Thames Valley District School Board does not provide any accidental death, disability, dismemberment or

medical expense insurance on behalf of students or parent/guardian/volunteer and supervisors for this activity”

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Please read and sign that you are aware of the terms outlined in this letter:

____________________________ _____________________________

Print Name (Student) Signature (Student)

____________________________

Parent Signature required for students under 18 years of age

Fanshawetransportationletter

FORM 4

On-going curricular field trips are defined as off-campus activities which are part of the curriculum and occur frequently as part of the program. Examples are physical education recreation courses including activities such as skating or golf, or music courses involving a schedule of off-campus concerts. On-going co-instructional field trips are defined as scheduled off-campus sporting events, performances or competitions. Examples are sports team league games, tournaments, and playoffs, choir performances and drama competitions. For all on-going curricular and co-instructional field trips, teachers will attach to this form a complete itinerary/schedule showing the times, locations, dates, transportation and other arrangements. Activity: Dual Credit Program at Conestoga College Teacher in Charge: Mr Don Macpherson/Mr Tom Smith Dates: Feb 23/18 to June 15/18 Activity: Dual Credit Program at Fanshawe College Teacher in Charge: Mr Don Macpherson/Mr Tom Smith Dates: Feb 22/18 to June 14/18 Activity: Dual Credit Program at Lambton College Teacher in Charge: Mr Don Macpherson/Mr Tom Smith Dates: Feb 16/18 to June 15/18

Note re: Elements of Risk: The risk of injury exists in every field trip activity. However due to the very nature of some activities, the risk of injury may increase. Injuries may range from minor sprains and strains to more serious injuries. The safety and well being of students is a prime concern and attempts are made to manage as effectively as possible, the foreseeable risks inherent in field trip activity.

has my permission to participate in the on-going

(Student’s Name)

curricular or co-instructional field trips as described in the attached itinerary/schedule for the current school year.

Date Signature of Parent/Guardian

Home Phone Work Phone

Notice of Collection: In accordance with Section 29(2) of the Municipal Freedom of Information and Protection of Privacy Act, 1989, the information provided is collected under the legal authority of Section 265 (1)(d) of the Education Act, R.S.O. 1990 c. E.2 as amended, and may be used as necessary for some or all of the following principal administrative purposes related to: the Board’s operation, school programs and educational services, student records, and Ministries of the Government of Ontario. If you have any questions, please contact the Principal and/or the Freedom of Information Co-ordinator, Thames Valley District School Board, 1250 Dundas Street, London, Ontario, N6A 5L1 (Telephone 519-452-2000, ext. 20218).

Program Services Revised 2008 March

PARENT/GUARDIAN PERMISSION FORM

FOR ON-GOING CURRICULAR AND

CO-INSTRUCTIONAL FIELD TRIPS

Date: ________________________

Letter to Parents/Guardians of Students being Video Recorded/Photographed - Internet

Dear Parents/Guardians,

Your child has chosen to participate in the Dual Credit/School With-in a College program through the Thames Valley District School Board for (within) the school year: Jan 2018 to June 2018

Details include: STUDENTS MAY BE ASKED TO PARTICIPATE IN UNIQUE CLASSROOM LEARNING PRACTICES OR FIELD TRIPS THAT MAY BE USED IN PROMOTION AS PROMOTIONAL MATERIAL OF PROGRAM. As part of this program, your child may be video recorded or photographed for demonstration and/or training purposes. This recording may be posted publicly on the Thames Valley District School Board corporate website and shared outside of TVDSB. This will allow us to share ideas and experiences with other teachers, administrators and community partners throughout the Thames Valley District School Board, with other boards and potentially with other members of the public. We require your parent/guardian signature in order to grant permission for your child to be video recorded/ photographed as part of this project. The video recording/photograph is for training or demonstration purposes and may be used over an indefinite period of time. If you have any questions, please contact Tom Smith at the TVDSB Education Centre, (519) 452-2000, ext. 20150. Sincerely,

Don Macpherson Superintendent of Student Achievement Learning Support Services Thames Valley District School Board

✁

Please return this portion of the form to the classroom teacher. Students 18 years of age or older do not require parents signature I give permission for my child, ____________________________, to be video recorded photographed as part of _________________________________ through the Thames Valley District School Board. I understand that footage may be shared publicly through posting on the Thames Valley District School Board corporate website with educators and community partners throughout Thames Valley District School Board and with other school boards and members of the public over an indefinite period of time. Date:_______________ Parent Name (please print): __________________________ Parent Signature________________________

Students Name (please print)___________________________ Students Signature______________________

Notice of Collection: The personal information provided on this form and any other correspondence relating to involvement in Board programs is collected by the Thames Valley District School Board under the authority of the Education Act and Regulations (R.S.O. 1990 c.E.2) as amended. The information will be used to register the student in a school as well as for any consistent purpose, and to share information with employees to carry out their job duties. In addition, the information may be used for matters of health and safety, or discipline and as required to be disclosed in compelling circumstances for law enforcement matters or in accordance with any other Act. For questions about this collection, contact the Board’s Freedom of Information Co-ordinator, Thames Valley District School Board, 1250 Dundas Street, London, Ontario, N6A 5L1, Telephone 519-452-2000, Ext. 20218.

Original: OSR Copy: Parent/Guardian or Student if Over Age 18 M:\All Applications\Master SWAC App\Fanshawe SWAC Apps\TVDSB-Consent of disclosure-page 7.doc Revised December 2011

CONSENT TO THE DISCLOSURE, TRANSMITTAL AND/OR EXAMINATION OF

RECORDS OR INFORMATION

I,

(Print name of Parent/Guardian and state relationship or student’s name if over age 18)

of

(Address and Telephone Number)

hereby consent to the disclosure or transmittal to or the examination by:

(School/Board, Facility, Agency or Individual)

in respect of

(Student Name) Date of Birth (YYYY/MM/D)

for the purpose of:

(Reason for Disclosure eg. Educational Planning)

Description of information to be disclosed: [check appropriate item(s)]

Any pertinent information

Educational Records

Records/Reports compiled in/by: [List name(s) of Agency, Facility or Practitioner Below]

This consent is valid for 1 year from the date signed:

Date (YYYY/MM/D)

I understand that I may revoke this consent in writing at any time before the duration of consent expires,

except where action has already been taken in reliance on the authorization.

Signature: Date (YYYY/MM/D):

(Signature of Parent/Guardian or student if over age 18)

Witness: Date (YYYY/MM/D):

SWAC Candidate Reference Letter

Applicant Name: _________________________________________________ Advocate Name: __________________________________________________

Advocate’s Position: Teacher Guidance Counsellor Administrator How many years have you known the applicant? ____ Select the criteria and/or factors that apply to the applicant:

This student previously dropped out and returned to secondary school.

This student has been identified with behavior problems (either in the past or presently).

This student is being approved for entry into the SWAC program by the home school Student Success Team.

This student requires special accommodations: physical, environmental, or medical: (i.e. Anaphylactic allergy, wheelchair, interpreter etc.)_______________________________

Discuss the reasons why you believe SWAC is the appropriate educational path for this student. What qualities and/or characteristics does this student possess that will make them successful at SWAC?

What are some ongoing issues or barriers this student may need help overcoming for them to be successful in the SWAC program?

SCHOOL WITHIN A COLLEGE (SWAC) APPLICATION PACKAGE CHECKLIST Please ensure when dropping off completed SWAC applications that all required information is complete and the application package is neat and legible. Please bring your complete application package to your Interview.

Where ever possible referral to the SWAC program will be guided through the student success team at the home school using the selection criteria

Age: 17 - 20 preferred Credits: 20 or more credits; preference given to students with greater than 24 credits Disengaged, but likely to succeed

The potential student should fill out a (SWAC) application The applications, a copy of the course credit counseling summary, and a copy of the students I.E.P. (if

applicable) should be available during the interview All students who have met the criteria and proceed to the mandatory interview will receive notification

if they have been accepted to the (SWAC) program after the interview process is complete Check List:

Items: Notes: Importance Check

SWAC/TVALT Application Applications with missing information or signatures will not be considered

To be completed and returned

Dual Credit Authorization and Consent Form

Must accompany the (SWAC) application

To be completed and returned

(SWAC) Student Expectations Form

This form must be complete with all required signatures

To be discussed at the time of interview.

Dual Credit Transportation/Attendance Letter

This form must be complete with all required signatures

To be discussed at time of interview

Dual Credit Field Trip Form This form must be complete with all required signatures

To be discussed at time of interview

TVDSB Media Consent Form Must accompany the (SWAC) application

To be completed and returned

Consent for Disclosure Form Must accompany the (SWAC) application

To be completed and returned

Reference Letter This form must be complete by a Teacher, Guidance Counselor, or Administrator

To be discussed at the time of interview.

A copy of the student’s course credit counseling summary

Must accompany the (SWAC) application

To be included with the application

A copy of the student’s Individual Education Plan (If applicable)

Must accompany the (SWAC) application

To be included with the application