Collaborative Education Alternative Program
School District No. 69 Qualicum
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266 Village Way, Box 1000, Qualicum Beach, BC, V9K 1T3| Phone: 250-752-5628| Contact Us
Registration

Pre-Registration Form

Pre-registration - Provides us with some basic information with which to begin the registration process. To complete registration, the following elements will also be required:

  • School District Registration form (if non- SD69 students)
  • CEAP program forms found on program pages of this website (Student Information, Collaborative Commitment & Funding Allocation Worksheet)
  • Refundable Resources Deposit ($75) may be required
  • Eligible course fees for Graduated Adults
  • Completion of first learning activity
  • Student Learning Plan Meeting (Full-time students)

A representative from the CEAP Program will contact you about your pre-registration

Please complete all parts of the form carefully.

Student's Full Name *
Last, First Name)
Student Date of Birth *
Select a date from the calendar.
Provide the student Date of Birth in M/D/YYYY format.
Current or Highest Grade Level Attained *
Please indicate the current or highest grade level attained, K to 12
Contact Phone Number *
Please provide a phone number at which the parent or adult student can be contacted.
Contact Email Address *
Please provide an email address at which the parent or adult student can be contacted.
Program or Course *
Please provide the following: For Full-time enrolment (CEAP is the only or main school attended - Provide the desired grade level). For part-time enrolment (Grades 8 - 12 only) - Provide the first course that you wish to take, knowing that other courses can be added later.
Comments or Enrolment Information
Please provide any pertinent information about yourself or the learner that will assist us in creating the best possible learning experience.
Grade Level Desired
For full-time students: Enter the overall grade level at which the student will be registered for in this registration.
Parent/Guardian Name *
First, Last Name
Attachments
    Captcha *