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St. Joseph SS Pre-Advanced Placement Registration Package Checklist: Please use this checklist as your COVER PAGE for the application *St. Joseph SS Pre-AP has a limited enrollment. Please take the time to thoroughly complete the application. *Please refrain from calling to enquire as to the status of your child’s application. The school will review the application and notify you by email. * Pre-AP Application for: (child’s name – clearly printed) _______________________________ *Current Elementary School:_______________________________________________________ Indicate your email address here: __________________________________________________ * Once a regional program offer is accepted, no other offers can be considered. A. Advanced Placement Registration Package Including: o Section I – Student Information o Section II – Pre-AP Course Selection o Section III – School Involvement o Section IV – Community Involvement o Section V – Awards and Distinctions o Section VI – Student Response B. Regular School Registration Package Including: o Course Selection Sheet (choose one elective course) o Registration and Information Form o Religious Expectations and Requirements o Website Permission Form o Personal Electronic Device Agreement o Network User Agreement/Release Form C. PLEASE ATTACH COPIES OF THE FOLLOWING DOCUMENTS: o TWO Proofs of Address (utility bills or tax bills, NO drivers licenses) o Copy of Canadian Citizenship or Perm. Resident Status Card for student o First Term Final Report Card with numerical marks (not the Interim Report Card with Learning Skills only). o Tax Form o Immunization Record (only required for students new to Ontario) o If available, include EQAO scores and any additional standardized test results x Packages must be complete to be accepted. x Please see our website for a complete list of application dates. x A $65 Activity Fee must accompany the application.

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Page 1: St. Joseph SS Pre-Advanced Placement Registration Package ... · St. Joseph SS Pre-Advanced Placement Registration Package Checklist: ... o Copy of Canadian Citizenship or Perm. Resident

St. Joseph SS Pre-Advanced Placement Registration Package Checklist: Please use this checklist as your COVER PAGE for the application

*St. Joseph SS Pre-AP has a limited enrollment. Please take the time to thoroughly complete the application.

*Please refrain from calling to enquire as to the status of your child’s application. The school will review the application and notify you by email.

* Pre-AP Application for: (child’s name – clearly printed) _______________________________

*Current Elementary School:_______________________________________________________

Indicate your email address here: __________________________________________________

* Once a regional program offer is accepted, no other offers can be considered.

A. Advanced Placement Registration Package Including:

o Section I – Student Information

o Section II – Pre-AP Course Selection

o Section III – School Involvement

o Section IV – Community Involvement

o Section V – Awards and Distinctions

o Section VI – Student Response

B. Regular School Registration Package Including:

o Course Selection Sheet (choose one elective course)

o Registration and Information Form

o Religious Expectations and Requirements

o Website Permission Form

o Personal Electronic Device Agreement

o Network User Agreement/Release Form

C. PLEASE ATTACH COPIES OF THE FOLLOWING DOCUMENTS:

o TWO Proofs of Address (utility bills or tax bills, NO drivers licenses)

o Copy of Canadian Citizenship or Perm. Resident Status Card for student

o First Term Final Report Card with numerical marks (not the Interim Report Card with Learning Skills only).

o Tax Form

o Immunization Record (only required for students new to Ontario)

o If available, include EQAO scores and any additional standardized test results

Packages must be complete to be accepted.

Please see our website for a complete list of application dates.

A $65 Activity Fee must accompany the application.

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ST. JOSEPH S. S.

REGIONAL AP PROGRAM APPLICATION FORM

FOR GRADE NINE

INFORMATION AND GUIDELINES

The Regional Advanced Placement (AP) Program at St. Joseph S. S. provides an enriched classroom setting for highly motivated students in the areas of English, French, Math, Science and Social Science. The program begins in Grade 9 with Pre-AP classes in which students study both the Ontario and the AP curriculum. Pre-AP courses in grades 9-11 lead to AP classes in Grade 12 (and Grade 11 American History) that prepare students to write AP exams for advanced placement or credit in university. All strong academic students are encouraged to apply.

The flexibility of the AP Program allows students to select the number of AP classes that suit their learning needs. Students from the Regional AP Program at St. Joseph S. S. may choose as few as one AP class or the full complement of AP courses offered at the school in order to work towards the AP National Scholar designation which is recognized world-wide.

St. Joseph S. S. will accept a limited number of students into the Regional AP Program in Grade 9 from across Mississauga. Admission to the program will be granted based on previous report cards, application form and the student’s desire to commit to the level of study required by the enriched classroom setting.

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SECTION 1: STUDENT INFORMATION

Student Name: (Please print) Surname Given Name(s)

Full Mailing Address: Street #, Street Name, Unit #

City: Postal Code: Telephone Number:

Parent email contact: ____________________________________________________________

Present Elementary School:

SECTION 2: PRE-AP COURSE SELECTION

Check the Pre-AP course(s) that you would like to take in Grade 9 and indicate your most recent report card grade in that subject.

Pre-AP Subject Desired Most Recent Report Card Grade

o Pre-AP English

Reading Writing Oral and Visual Communication

o Pre-AP Math

Number Sense Measurement Geometry Data Management Patterning and Algebra

o Pre-AP French

Oral Communication Reading Writing

o Pre-AP Science Science and Technology

o Pre-AP Social Science

Geography History

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SECTION 3: SCHOOL INVOLVEMENT

Please list any school club or teams and activities in which you have been involved in the past two years. (Some examples might include: student council, office helper, volleyball team, etc.)

ACTIVITY DATE

SECTION 4: COMMUNITY INVOLVEMENT

Please indicate any activities in which you have participated during the past two years. (Some examples might include: music lessons, sports teams, volunteer work, scouts, etc.)

ACTIVITY DATE

SECTION 5: AWARDS AND DISTINCTIONS

Please list any awards or recognitions that you have received from your school or community. (Some examples might include: academics, leadership, music, athletics, public speaking, contests, etc.)

ACTIVITY DATE

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SECTION 6: STUDENT RESPONSE

In a presentation (written format of approximately 200-250 words, video of 2-3 minutes or visual cube of maximum 10X10 cm. squares) please indicate why you are applying to the Regional AP Program at St. Joseph S. S. What do you hope to gain from the program? What strengths will you bring to the program? (Please attach your response to this application.)

APPLICATION FORM CHECKLIST If you wish to be considered for the Regional AP Program please ensure that you forward your completed application to St. Joseph S. S. by the dates indicated on the AP section of the St. Joseph SS website. Please refer to the cover page checklist provided on our website to ensure that your application is complete before submitting it. The regular registration package MUST accompany this application.

Parent/Guardian Signature: Date:

Student Signature: Date:

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St. Joseph Secondary School 5555 Creditview Road, Mississauga, ON L5V 2B9 Tel (905) 812-1376 A. Bomben - Principal

Registration/Course Selection Grade Nine 2018 – 2019

Name: Current School: If you have made any changes to your personal information, please inform your current school immediately, so that we may accurately transfer your files to St. Joseph Secondary School. Course selection will be on myBlueprint.ca and will also be on this form. Note: If you are applying for AP courses, please complete the AP Registration package in addition to this form. Course Selections for

2018 - 2019 Course Code

(Student circles one selection)

Religion HRE101 English ENG1D1 ENG1P1 ENG1L1 PRE-AP Mathematics MPM1D1 MFM1P1 MAT1L1 PRE-AP Science SNC1D1 SNC1P1 SNC1L1 PRE-AP Geography CGC1D1 CGC1P1 PRE-AP French* FSF1D1 FSF1P1 PRE-AP Physical Education PPL1OM PPL1OF Elective (one selection)

Drama Music Art Bus. Technology (BTT)

Intro. To Business (BBI) Integrated Technologies (TIJ)

Identified Learners Only GLE1O1 *Substitutions for French will only be granted if this is documented in the IPRC held when the identified learner is in Grade 8.

Note: Course level selection or program decisions agreed upon at the IPRC will override the course selections provided above.

______________________________ ______________ ________________________________ Student Signature Date Parent Signature

TO BE COMPLETED BY ST. JOSEPH S.S. GUIDANCE : $65.00 Activity Fee Enclosed Date Received: __________________________ Cash or Cheque (payable to St. Joseph SS) Please put student’s full name and Elementary school on cheque.

$65 FEE:

Student Activities incl. yearbook $30 Faith Formation, Initiatives and Retreat $20 Civvie’s Day / Student Council $15

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Year Month Day

Student Registration and Information Form – Secondary School

The Mission of the Dufferin-Peel Catholic District School Board, in partnership with the family and church, is to provide, in a responsible manner, a Catholic education which develops spiritual, intellectual, aesthetic, emotional, social, and physical capabilities of each individual to live fully today and to meet the challenges of the future, thus

enriching the community

STUDENT PERSONAL INFORMATION PART 1

Legal Names: (Students are registered by their legal name which will be used on legal documents. The student’s preferred name will be used at school)

Surname: First Name: Middle Name:

Preferred Names: Same as Legal Names, or

Surname: First Name: Middle Name:

Does this student identify as: Female Male Birthdate:

Previous school attended: First day of entry to any school in Ontario:

Previous School Board: ________________________________

If the student is entering from outside of Ontario, please indicate name of

Does this student have sibling(s) in this District School Board? Yes No If yes: Elementary Secondary

If yes, provide full name(s):

Does this student have sibling(s) in another District School Board? Yes No

If yes, state name of District School Board:

Is this student Roman Catholic, or, in an Eastern Church in full communion with the Holy See of Rome? Yes No

Medical Condition(s)/Alert:

Custody Information

Who has legal custody? Both parents Father only Mother only I am 16/17 years of age and have Other _______________________ withdrawn from parental control

Are there any special arrangements pertaining to access/visitation? No Yes – Documentation provided

If yes, then the most recent original Court Order to support custody must be provided (a verified copy to be stored in the OSR)

Year Month Day

Territory/Province/Country

Page 1 GF 008 S Revised Jan 16

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Number Street Unit Type (e.g. Apt.) Unit #

Year Month Day Year Month Day

Student’s Country of Birth: If Canada, Province of Birth:

Arrival Date (into Canada): Expiry Date (if applicable):

Student’s Country of Birth: If Canada, Province of Birth:

If arrived within the past five years, complete the ‘Confirmation of Pupil Eligibility . . .’ form (GF008.1).

Status in Canada: ( one) Canadian Citizen Permanent Resident Refugee Permanent Resident Pending Temporary Resident Parent on Work Permit

International Student Parent on Study Permit Student on Study Permit

Country of Last Residence: Country of Citizenship:

ABORIGINAL STUDENT (Voluntary Self-Identification): For the purposes of supporting First Nation, Métis and Inuit student achievement objectives of Dufferin-Peel and the Ministry of Education, and of reporting student achievement to the Ministry of Education and the Education Quality and Accountability Office, I / we choose to voluntarily self-identify my/this child’s ancestry as:

First Nations Inuit Métis First Nation Métis and Inuit Ancestry

STUDENT ADDRESS

( ) City Postal Code Phone #

Mailing Address (if different from above):

Proof of Residence Sources: ___________________________________________________ (e.g., property tax bill, current utility bill, real estate document, or Government of Canada issued forms)

Please indicate if this student: lives in a group home lives independently of parent or guardian has recently enrolled in a CCTC program (Care, Treatment, Custody, Corrections)

PARENTAL/GUARDIAN CONTACT INFORMATION

Emergency Priority (Circle one): 1 2 3 4 Speaks English

Title First Name Last Name Relationship to Student

Address: Same as student or

Home Phone: Same as student or Business Phone

Cell Phone: Alternate Phone:

STUDENT PERSONAL INFORMATION PART 2

( )

( )

( ) Ext.

Separate School Supporter: Yes No

( )

Page 2 GF 008 S Revised Jan 16

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Emergency Priority (Circle one): 1 2 3 4 Speaks English

Title First Name Last Name Relationship to Student

Address: Same as student or

Home Phone: Same as student or Business Phone:

Cell Phone: Alternate Phone:

Emergency Contact (other than parent/guardian/caregiver):

Emergency Priority (Circle one): 1 2 3 4 Speaks English

Title First Name Last Name Relationship to Student

Address: Same as student or

Home Phone: Same as student or Business Phone:

Cell Phone:

ADDITIONAL INFORMATIONLanguage(s) spoken by student:

First Language Spoken at Home Remark:

First Language Spoken at Home Remark:

First Language Spoken at Home Remark:

Special Education:Does student have special education/diverse learning need? Yes No

Does student have specialized equipment? Yes No SEA Yes No

In your previous school/board, was this student involved in special education programs and/or services? Yes No

Does this student have an Individual Education Plan (IEP)? Yes No

Has this student been identified as an exceptional student, through the Identification Placement Review Committee (IPRC)? Yes No

If yes, date of most recent IPRC review, as appropriate: ________________________________

Is the student’s transition plan attached to the IEP? Yes No

English Language Learners (ELL)In your previous school/board, did this student receive ESL/ELD services? Yes No

SAFE SCHOOLS

Suspension/Expulsion 1. Are you, or the student being registered currently serving a suspension? Yes No 2. Are you, or the student being registered currently participating in a program for suspended students? Yes No 3. Are you, or the student being registered expelled from any school and, if yes, have you/they successfully

completed a program for expelled students? Yes No

Gender: Female Male

( )

( )

( ) Ext.

Page 3

Separate School Supporter: Yes No

( )

( )

( ) Ext.

Ext. ( )

GF 008 S Revised Jan 16

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Under Canada’s Anti-Spam law (CASL) the Dufferin-Peel Catholic District School Board requires your consent to send you electronic messages about commercial activities. While much of our email communication is about school, school council or Board news and activities, we may also send electronic messages of a commercial nature. This would include newsletters and other communications about such things as field trips, yearbooks, uniforms, school pictures, fundraising activities and events,food and drink purchases, books, prom or dance tickets, sporting/athletic events or similar events and offers.

If you wish to receive the above electronic communications from us, please provide your email address below. Your consent remains in effect as long as the student attends a DPCDSB school unless you withdraw it. If you have any questions, or wish to revoke your consent at any time please contact your school principal. Signature of Parent/Guardian: Email Address: (or Student if 18 years of age or older – OR – if you are 16/17 and have withdrawn from parental control)

R.O.P.S.S.A.A. PLEASE NOTE:1. A school transfer could affect eligibility to participate in Board approved athletics. “Any student who attended another

secondary (anywhere) in the previous 12 months must be approved by the ROPSSAA Transfer and Eligibility Committee prior to participating in ROPSSAA activities”.

2. Admission to this secondary school is considered to be conditional pending receipt and review of the student’s records from his/her previous school.

PLEASE NOTE: Falsifying information on this form may rescind the admission to this secondary school

Signature of Parent/Guardian: Date: (or Student if 18 years of age or older – OR – if you are 16/17 and have withdrawn from parental control)

Signature of Principal/Designate: Date:

Personal information collected shall be used to establish and/or maintain the student’s Ontario Student Record (OSR) for the provision of educational services and to administer health and/or medical emergency responses to the student as required. In keeping with the requirements of the Education Act, the OSR and other information required to establish an appropriate program for the student shall be requested from the former school.

Information is collected under the authority of the Education Act, R.S.O. 1990, c. E.2, (s.170, s.190, s.264, s.265); Sabrina's Law, 2005, S.O. 2005, c. 7 and Ryan’s Law (Ensuring Asthma Friendly Schools), 2015, S.O. 2015, C. 3 in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Any questions regarding information collected, may be directed to the school principal or to the Records Management and Access & Privacy Administrator, 40 Matheson Blvd West, Mississauga, ON L5R 1C5 (905) 890-1221 ext. 24443

Canada’s Anti-Spam Law Consent

SIGNATURES

Office use only

School: ________________________Grade: _____ Teacher: ___________________ Start date:_____________

Documents to be filed in the OSR:

Academic Transcript of marks Newcomer Reception Centre Report Application for Direction of School Support/Lease P.E.D. (Personal Electronic Device) Agreement Confirmation of Pupil Eligibility (GF008.1) Network User Agreement IEP Documentation Flex Boundary Documentation IPRC Documentation Medication Forms Registration form Copy of most recent Original Custody Order if applicable (original document to be viewed and verified)

Original documents to be viewed and verified but not filed in the OSR

Birth Certificate Citizenship/Immigration/Intl. Student Verification Immunization Certificate or Statement of Medical Exemption (copy only sent to Peel or Wellington-Dufferin-Guelph Public Health) Proof of Residence Sources: ___________________________________

(e.g., property tax bill, current utility bill, real estate document, or Government of Canada issued forms)

CC: Copy to be filed in the OSR Page 4 GF 008 S Revised Jan 16

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GF 010

SECONDARY SCHOOL RELIGIOUS EXPECTATIONS AND REQUIREMENTS - LETTER OF ACKNOWLEDGEMENT -

TO BE COMPLETED UPON INITIAL SECONDARY SCHOOL REGISTRATION IN DUFFERIN-PEEL Thank you for choosing to enroll your son/daughter in one of our Catholic secondary schools. The Dufferin-Peel Catholic District School Board (the “Board”) is committed to providing a quality Catholic education which views human life as an integration of body, mind and spirit. Rooted in this vision, Catholic education fosters the search for knowledge as a lifelong spiritual and academic quest. The expectations of Catholic school graduates, therefore, are described not only in terms of knowledge and skills, but in terms of values, attitudes, and actions. The Ontario Catholic School Graduate is expected to be: a discerning believer; an effective communicator; a reflective, creative and holistic thinker; a self-directed, responsible, lifelong learner; a collaborative contributor; a caring family member; and, a responsible citizen. The Board supports freedom of religion and an individual’s right to manifest his/her religious beliefs and observances. The right to freedom of religion, however, is not absolute and religious accommodation in the Board is carried out in the larger context of the Catholic educational system and denominational rights of Catholic schools. The Board recognizes that any form of discrimination is incompatible with Catholic moral principles and is in violation of the Ontario Human Rights Code. The Board recognizes that the school system gives pre-eminence to the tenets of the Catholic faith, congruent with the protection afforded in the Ontario Human Rights Code, the Constitution Act, 1867 and confirmed in the Canadian Charter of Rights and Freedoms. The Board and its staff are committed to the elimination of discrimination as outlined in Ontario’s Equity and Inclusive Education Strategy and the Ontario Ministry of Education Policy/Program Memorandum No. 119, in a manner which is consistent with the exercise of the Board’s denominational rights under section 93 of the Constitution Act, 1867 and as recognized in section 19 of the Ontario Human Rights Code. The historical mandate of the Catholic school system in Ontario is to infuse the entire syllabus, and related activities of the school on the life and teaching of Jesus. As such, the Dufferin-Peel Catholic District School Board has the expectation that all students admitted to the Catholic system will benefit from these values and teachings and be formed into responsible, reflective and well-rounded citizens. Our religious expectations and requirements for the duration of a student’s tenure are as follows: 1. All students will enroll in a Religion course in each of the four years. All Religion courses are approved by the

appropriate Catholic authority. The Government of Ontario recognizes that Religion credits count towards a secondary graduation diploma.

/Continued

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SECONDARY SCHOOL RELIGIOUS EXPECTATIONS AND REQUIREMENTS - LETTER OF ACKNOWLEDGEMENT - Continued…

(Revised January 2013)

2. All students will participate in an annual retreat for the first four years that they are in a secondary school. The retreat normally takes place during the school day at a site off school property. The chaplaincy leader organizes the annual retreat based on spiritual themes appropriate for adolescents.

3. All students will participate in the prayer and liturgical life of the school. Catholic students are expected to participate fully as mandated by their sacramental Baptism. Non-Catholic students are expected to participate to the extent that they can. It is not the intention of the Dufferin-Peel Catholic School Board to proselytize. However, for supervision, safety and community reasons, the entire school participates in all religious events that occur during the school year. At a minimum, non-Catholic students will attend and maintain respectful silence at all religious observances. All students are encouraged to get involved.

4. Students requesting accommodations must present written notice from their parent(s)/guardian(s) specifying their accommodation needs relating to religious observances, including holy days on which they will be absent from school. This notice should be made in advance (preferably at the beginning of each school year) to ensure that scheduling of major evaluations, such as tests, assignments or examinations, takes the religious observances into consideration.

5. The Catholic District School Boards of Ontario follow approved provincial curriculum. Given the distinctiveness of Catholic schools, the Government of Ontario recognizes parallel curricula for our system. All courses in all subject areas in our Catholic secondary schools are infused with core Catholic values and teachings. Regardless of the subject matter, the Catholic ethos, and moral value system is reflected throughout the curriculum, and as such, is inextricable from delivery.

In order to complete your child’s registration package, we ask that upon review of the expectations outlined in this letter, you acknowledge its receipt.

We know your child will find their experiences in our Catholic secondary schools rewarding and we look forward to joining with you in supporting your child during these formative years.

I acknowledge that I have received and reviewed the Religious Expectations and Requirements for secondary school registration.

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(November 2012)

GF 338 A

CONSENT FORM FOR POSTING STUDENT'S PERSONAL INFORMATION

ON A SCHOOL'S WEB-SITE

This Consent Form meets the requirements of the Municipal Freedom of Information and Protection of Privacy Act and the Education Act for the disclosure of personal information. It provides for consent that is both informed and voluntary, and relates to clearly identified information to be used and disclosed for clearly defined purposes. By signing this document, I/we consent to the disclosure of personal information about ___________________________________________________ (name of student) by posting it to the Web-site of _____________________________________________________ and hence to the World-Wide Web. (name of School) This consent only applies to the items below that I/we have initialled: _________ Photograph of _________________________________________________________________

(Name of student) _________ Group and class photographs including _____________________________________________

(Name of Student) _________ Essays written by _______________________________________(Name of Student) _________ Projects done by ________________________________________(Name of Student) Awards, scholarships, prizes received by _________ ____________________________________________(Name of Student) _________ Participating of _________________________________________(Name of Student)

in any extracurricular activities

(Other specific activity identified by school….please specify) _________ _______________________________________________________________________________ I/we have read and understood the Dufferin-Peel Catholic District School Board's policy on School Web-Sites. I/we are aware that by giving this consent, I/we are permitting personal information about ____________________________________________________________________________ (name of student) to be posted to the _______________________________________________________________ (School's Web-Site) and hence to the World-Wide Web, and that if consent were withheld, this posting would not occur. I/We further understand that this consent is valid for one year and may be withdrawn by me/us at any time, upon written notice. In the event that consent is withdrawn, I/we understand that the information about me will be removed from the Schools-Web-site, but understand that, in some cases, it is impossible to remove all traces of personal information from the Internet.

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(November 2012)

I/we have given this consent voluntarily.

____________________________ on ___________________________________ (place of signature; e.g. City) (date) a) For students under 16 years of age: signature of parent (or legal guardian). _________________________________ ____________________________________ Signature of Parent or Legal Guardian Witness _________________________________ ____________________________________ Signature of Parent or Legal Guardian Witness b) For students aged 16 or 17 during the school year: signature of both the student and parents (or legal guardian) ________________________________ ____________________________________ Signature of Student Witness ________________________________ ____________________________________ Signature of Parent or Legal Guardian Witness ________________________________ ____________________________________ Signature of Parent or Legal Guardian Witness c) For students 18 years of age or over: signature of student ________________________________ ____________________________________ Signature of Student Witness

Notes: Only persons having lawful custody of the student may sign this consent form as parent or legal guardian. In cases of joint custody, it is advised that both parents provide consent. For those situations where an individual whose consent is required is mentally incapable and a substitute decision maker has been appointed under Ontario Law to act on his/her behalf, then the individual appointed as substitute decision-maker should sign the consent form.

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PERSONAL ELECTRONIC DEVICE USED WITH WI FI NETWORK STUDENT AGREEMENTDufferin Peel Catholic District School Board policies and procedures support the use of personal electronic devices (PEDs) for educationalpurposes. This agreement will be signed when your child registers to attend a school within Dufferin Peel Catholic District School Board.

In compliance with the Catholic Code of Conduct and other board policies and procedures including, but not limited to the StudentNetwork User Application and Agreement, any student opting to use a PED while on school premises for educational purposes is requiredto adhere to the following:

Part A.1. We understand that if I bring my PED to school I must follow board and school policies and procedures regarding appropriate

use of technology.2. We will be a responsible digital citizen by adhering to guidelines regarding content, security, safety and ethical use through

appropriate use of technology, as outlined in the Catholic Code of Conduct and other board policies and procedures.3. We will accurately represent myself while online and that my online interactions are reflective of our Gospel values and virtues.4. We understand that PEDs may be used during instructional time and in instructional space only with the expressed permission

of the classroom teacher and/or staff and only in a manner that supports the teaching learning process.5. We understand that I may use my PED in common areas for educational purposes, as designated by the principal.6. We will not share my password with others and I will respect the privacy of other people. I will not share other people’s

passwords or personal information.7. We understand that upon reasonable grounds, staff reserve the right to review material viewed, created or saved on my

authorized registered PED and/or other personal electronic devices.8. We understand that no school and/or board data is allowed to be stored on PEDs.9. We will not use my PED in a manner that will harm the board’s system or another person's work.10. We understand that if I bring my PED for use on board premises I am responsible for the safety and security of that device at all

times and the board assumes no responsibility for lost, damaged or stolen devices.11. We understand that we should not have the expectation to be able to charge our device at school.12. We understand that photos, videos or images of an individual/group are not permitted to be taken without expressed consent.

Expressed consent must be obtained from the individual(s) over the age of 18—or parental/guardian consent (for those underthe age of 18).

13. We understand the school administration will be the arbiter of what constitutes a violation of this agreement. Any failure tocomply with these guidelines may result in confiscation of my PED, discipline, a loss of PED privileges, police involvement and/orany other consequences deemed necessary by school administration.

14. We agree, by virtue of access to the board’s computing and electronic communication systems, to indemnify, defend and holdharmless the board for any suits, claims, losses, expenses or damages, including but not limited to litigation costs and legal fees,arising from or related to the user’s access to or use of board electronic communication and computing systems, services andfacilities.

Part B.1. We understand that I am responsible to take the necessary steps to ensure my authorized PED is connected to the board wireless

network, and that the board will not be responsible for any cost incurred through the use of personal data plans.

I acknowledge that I have read, understand and agree to abide by the PERSONAL ELECTRONIC DEVICE USED WITH WI FINETWORK STUDENT AGREEMENT.

School Name of Student (please print)

Student Signature Date

Parent/Guardian Signature Date

Copy to the student and/or parent/guardian

GF 337

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(November 2012)

GF 066

NETWORK USER APPLICATION AND AGREEMENT

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Network User Application and Agreement - 2 -

I acknowledge that I have received and will abide by the Network User Application and Agreement and that this Agreement remains in effect for the duration of the student’s tenure in this school system.

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