Registration Package - from non-DDSB school

GL Roberts CVI
399 Chaleur Avenue
Oshawa ON L1J 1G5
[email protected]
tel: 905-728-7594
fax: 905-728-7760
www.GLRobertsCVI.ca
Pre-Admission Package
Thank you for your interest in attending GL Roberts Collegiate and Vocational Institute.
1. Complete the attached forms:
 Student Registration Form
 Application for Direction of School Support
 Immunization Information Form
 Computing and Information Technology Facilities and Resources Acceptable and
Safe Use Procedure: Parental Consent Form
 First Nation, Métis, and Inuit Student Self-Identification (if applicable)
2. Obtain and attach the following documents with this package:
 Official Transcript or Status Sheet
 Attendance Record for the most recent school year
 Individual Education Plan (if applicable)
 Record of Community Service Hours (if applicable)
 Ontario Secondary School Literacy Test results (if applicable)
 Proof of Citizenship (Birth Certificate or Passport)
 Proof of Residency Status and Record of Landing (if not born in Canada)
 Proof of Residency (e.g., Purchase Agreement of new home, Ownership Title,
Lease/Rental Agreement, Property Tax Assessment)
 Proof of Custody (court order and/or Consent for Guardianship, as appropriate) if
the student does not reside with both parents (children in foster care must have a
Children’s Aid Society worker present at the registration appointment)
3.
Mail, fax, email, or deliver all documents to the attention of the Guidance Office.
GL Roberts CVI
399 Chaleur Avenue
Oshawa ON L1J 1G5
4.
Fax: 905-728-7760
Email: [email protected]
If your application has been accepted, you will be contacted to schedule an interview with a
vice-principal. The scheduling of an interview does NOT guarantee acceptance to GL
Roberts Collegiate and Vocational Institute.
Student Information
Last Name
First Name
Middle Name(s)
Previous School(s)
Phone Number
Reason for Leaving
Performance at Previous School(s)
During the pre-registration interview, be prepared to discuss your academics, behaviour, and
attendance at your previous school(s).
School and/or Community Supports
Please indicate which (if any) of the following services and/or agencies are or have been
involved with your child’s programming:
 Occupational Therapist
 Psychological Services
 Speech and Language Therapy
 Social Worker
 Attendance Counsellor
 Other: ______________________________
Parent/Guardian Acknowledgement (if student is under 18)
Your signature indicates that the information contained within this pre-registration package is
complete and accurate. Students under the age of 18 must be accompanied by a parent or legal
guardian AND by a custodial guardian (as applicable) at the interview.
Signature:
Date:
~~ ~U""'l.'
DURHAM DISTRICT SCHOOL BOARD
STUDENT REGISTRATION FORM
,-
Shaded Area For Office Use
(Please Print Clearly)
Ww'N.durha.m.edu,on.ciI
School No.
School Name
Student Information
Legal Last Name, First Name, Middle Name
Gender
Male 0
Preferred Last Name, First Name (same as above 0)
Date of Birth:
Year (yyyy) Month (mm) Day (dd)
I
I
House Number Apt/Unit
(if rural include
911 number)
Female 0
Home Phone Number
Proof of Age Document
Grade
Street Name
Homeroom
Unlisted 0
Status
Proof of Address
Overflow 0
Out Of Area 0
Cityrrown
Postal Code
(if rural include Lot and Concession Number only)
Mailing Address
Previous School I Board
(if different from above include CitylTown)
Language of Instruction at Previous School
Has the student been identified through an Identification Placement Review Committee? Yes 0 NoD
Does the student have an IEP? Yes 0 No 0
If so what is the IPRC Identification:
Has the student been receiving English as a Second Language (ESL) assistance? Yes 0 NoD
Lunch (Elementary Students Only)
Does the student stay at school for lunch?
Yes 0
NoD
Parent lunch Note on File
Does the student occasionally stay for lunch at school? (please notify the school of dates)
Yes 0
NoD
Yes 0
Can the student leave school properly with a note?
Yes 0
NoD
NoD
Citizenship
Country of Birth
If born outside Canada, date of
entry into Canada
Year( yyyy) Month (mm) Day (dd)
If Canada, Province of Birth
I
Canadian 0
Permanent Resident 0
Student Visa 0
Parent WorkNisa 0
Refugee 0
Student Bom Outside Canada
Verification Document on file
Yes 0 No 0
Tuition Paid Directly to the Board
Aamit Reason
Student Visa 0
First Nation Education Authority 0
Admit Date
First Language
Language Spoken at Home
Voluntary First Nation, Metis, and Inuit Self-Identification
All parents/guardians of Aboriginal students, and students who are 18 years or older, have the right to voluntarily and
confidentially self-identify their Aboriginal ancestry.
If the student is considered to be of Aboriginal ancestry, please check appropriate box:
(Supporting documentation is not required.)
First Nation (Status or Non-Status) 0
Metis 0
Inuit 0
I
Parent/Guardian
Court Order Filed in
OSR
Custody
Both Parents 0
Joint 0
Crown
Special Arrangements 0
0
Exclusive 0
Parent 1 (Primary contact) Last Name, First Name
Address
Yes 0
NoD
Relationship to Student
Home Phone
(if different from student's)
Student Living with:
(if different from student's)
Lives with student
Yes 0
Willing to volunteer
at school?
Yes 0
Can be contacted at work?
Yes 0 No 0
Cell Phone
Business Phone
Parent 2 Last Name, First Name
Address
e-mail Address
Relationship to Student
Home Phone (if different from student's)
(if different from student's)
Lives with student
Yes 0
Willing to volunteer
at school?
Yes 0
Can be contacted at work?
Yes 0 No 0
Cell Phone
Business Phone
Guardian Last Name, First Name
Address
e-mail Address
Relationship to Student
Home Phone (if differenl from student's)
(if different from student's)
Lives with student
Yes 0
Willing to volunteer
at school?
Yes 0
Can be contacted at work?
Yes 0 No 0
Cell Phone
Business Phone
e-mail Address
Siblings Attending a Durham Elementary or Secondary School
Surname
First Name
School Attending
(if different)
Grade
Emergency Contact
Emergency Contact
(Other than parents/guardian)
Phone Number
Relationship
Permission to pick up student
Yes 0
Medical
Phone Number
Doctors Name
Permission to transport student by ambulance if necessary
Health Card
Yes 0
NoD
If the student has a DANGEROUS life threatening medical condition a
response plan will be created for the student to address individual needs.
Please see the Principal for additional information/permission forms to
support a life threatening medical condition.
Health conditions and/or allergies that are life threatening
If Yes, give details
Yes 0
(optional)
Eplpen® Provided
Yes 0 NoD
Epipen® Form on File
Yes 0 NoD
NoD
Allergy Alert Form on File
Yes 0 NoD
Medication administered at school
If Yes, give details
Yes 0
NoD
Request for Administration of Oral
Medication Form on File
Yes 0 NoD
Student wears a MedicAlert®
Yes 0
Request for Administration of Medication by
Injection in Emergency Situations Form on File
NoD
Yes 0 NoD
Registration No.
Potassium Iodide Pill
The following only applies to parents with students attending schools within a 10km radius of either Pickering or Darllngton Nuclear
Generating Stations. All schools within the radius have a copy of the Durham District School Board's Nuclear Emergency Procedures.
In the event of a serious accident at the Nuclear Generating Station, radioactive material may escape from the station. One type of
radioactive material that may be released is radioiodine. If radioiodine is inhaled, it is absorbed by the thyroid gland, The ingestion of
potassium iodide (KI) pill will minimize the amount of radioiodine absorbed by the thyroid gland. It is expected there Will be sufficient
time to close the school and evacuate your child before any radiation exposure occurs. However, a decision has been made to predistribute KI pills to all schools within a 10km radius. All principals have been instructed that the issue of these pills is sUbject to
Provincial Authorization.
There may be some reaction to the KI pills for individuals allergic to iodine. For this reason, it is important for parents to notify the
school if they suspect or know their child is allergic to Iodine. For questions regarding thyroid-blocking potassium iodide, please contact
the Regional Municipality of Durham Health Dept. at 905-723-3818 ext. 2188 or 1-888-777-9613 ext. 2188.
I grant permission for my child to be administered a KI pill
Yes 0
NoD
My child is allergic to iodine 0
Alternate Address/Chiidcare
Alternate address/Childcare Provider
(if applicable)
Phone Number
Before School
After School
Address is busing
Address is busing
Pick Up 0
Drop off 0
Other
0
Other
0
Address is busing
Address is busing
Pick Up 0
Drop off 0
Other
0
Other
0
Waivers
I have read the Acceptable and Safe Use Procedure form (available on the DDSB website
and at your child's school) and I give permission for my child to access the internet while at school.
I give consent 0
I do not give consent 0
I give consent 0
I do not give consent 0
I give consent 0
I do not give consent 0
I give permission for my name and phone number to be used by School Community Councils
for the purpose of sharing school information.
I give consent 0
I do not give consent 0
My child's school work, may be displayed in school buildings (other than the student's
classroom), school or board publications, website articles in the media.
My child's photograph/visuallikeness may be displayed in school buildings (other than
the student's classroom), school or board publications, website, articles in the media.
I give permission for my child to be included in neighbourhood excursions under
a teacher's supervision.
I give consent 0
I do not give consent 0
Emergency School Closure
During inclement weather, the Board may attempt to keep schools open but this does not mean that students must be sent to school.
It is the parents' responsibility to decide If conditions are safe for their children to walk to and from school. Listen to radio
announcements early in the morning. When buses are cancelled in the morning they will not run in the afternoon.
In case of inclement weather or an emergency due to lack of heat, water or a gas leak, etc., I grant permission for my child to be sent
Yes 0 No 0
home.
If your child is NOT to be sent home please specify alternate arrangements:
-~------
Suspension/Expulsions
Is this student currently suspended from any school in Ontario? If yes provide name of the school and the board
Has this student ever been expelled from any school in Ontario? If yes, provide name of the school, the board and a contact name
Graduation Requirements (Secondary Students.Only)
Documentation of completed Community Service Hours: Hours
Grade 10 Literacy Test successfully completed (please provide proof of results)
Yes 0
No 0
Privacy of Confidential Information
In accordance with the Municipal Freedom of Information and Protection of Privacy Act, 1989, 529(2), personal information
is collected under the authority of Education Act R.S.O. 1980, c 129, 5.10, and will be used for the general administration of
our schools.
Questions about this collection should be directed to the Superintendent of Education/Employee Relations, Durham District
School Board, 400 Taunton Rd. E. Whitby, ON L1R 2K6, 905·666·5500.
I understand that it is my responsibility to advise the school immediately of any changes in information stated on this form.
I acknowledge that the school accepts no liability for thefts which may occur on the school premises.
Date:
Signature of Parent/Guardian or Student 18 years and older:
Administration has reviewed the form
Date:
Signature of School Administrator:
Application for Direction of School Support
under section 16 of the Assessment Act
Demande d’affectation des taxes scolaires
en vertu de l’article 16 de la Loi sur l’évaluation foncière.
An application must be made to the Assessment Commissioner to
include or revise school support on the assessment roll.
Pro perty Iden tifier / Iden tification d e pro priété
NBHD
Q u a r ti e r
Po ur a joute r ou mo difier l’affe ctatio n d es ta xes sco laires sur le rôle
d’évaluation, il faut soumettre une demande au commissaire a l’évaluation.
C ou nty
C om te
Mun
Mun.
M ap /D iv
Pla n/d iv .
Map/Sub
P l a n /s e c .
Parcel
Pa rce lle
P r im / S u b
P r in c / se c
Ins truc tion s: se e re ve rse sid e / voir au verso
Please enter or revise my school support designation on the assessment roll in accordance with the following information.
Veuillez inscrire ou modifier l’affectation de mes taxes scolaires sur le rôle d’évaluation selon les renseignements ci’après.
Mu nicipality / Mu nicipalité
Ad dres s of P roperty / Ad ress e de la prop riété
Unit/A pt / Logement /App.
Res idenc e Te l. No. / N° de t el.(d om icile)
Ma iling A ddres s - if different from abo ve / Adresse postale - si autre que ci’dessus
Street No.,Name, P.O. Box, RR# / N° et rue, C.P., R.R.
Com plete for ru ral areas only / Remplir dans les
ces des zones rurales seulement
City / Ville
Province/Province
Country/Pays
Postal Code/Code postal
Lot N o./N° de lot
Bu sines s A ddres s - if self-em ployed o r in partne rship in bu sines s / Adresse comm erciale - comm erçant indépendant ou société de personnes
Plan/Conc No.
N ° d e p la n / c o nc .
Bu sines s Te l. No. / N° de tel. (bureau)
List oth er prop erties tha t you ow n or ren t in the M unicipality or Re gion / Indiquez les autres propriétés que vous possédez ou louez dans la municipalité ou la région.
Pleas e A nsw er All Qu estion s B elow. / Veuillez répondre à toutes les questions ci-dessous.
For S cho ol Boa rd Us e O nly / Rés ervé au c ons eil scola ire
B
C
Occupants Status
Statut de l’occupant(e)
1. Owner
Pro priétaire
This person lives:
Cette personne demeure:
2. Tenant
Loc ataire
1. At above address
à l’ad res se indiq ué e cidessus
3. Spouse
Conjoint
4. Child,
boarder, etc.
En fant,
pen sion naire
etc.
A
Res ident (Please Print) Résident(e) (S.V .P.)
First N am e(s) / P r é n o m ( s )
1
2
Male
Homme
Female
Femme
G
B ir th / N a is s a n ce
y e a r / a nn é e
Month
moi
Day
Jour
G
Canadian Citizen
Citoyen canadien
Yes
oui
G
3
G
No
Non
4
Las t Nam e / No m de f am ille First N am e(s) / P r é n o m ( s )
1
2
Male
Homme
Female
Femme
G
B ir th / N a is s a n ce
y e a r / a nn é e
Month
moi
Day
Jour
G
Canadian Citizen
Citoyen canadien
Yes
oui
G
3
G
No
Non
4
Las t Nam e / No m de f am ille First N am e(s) / P r é n o m ( s )
1
2
Male
Homme
Female
Femme
G
B ir th / N a is s a n ce
y e a r / a nn é e
Month
moi
Day
Jour
G
Canadian Citizen
Citoyen canadien
Yes
oui
G
3
G
No
Non
4
Las t Nam e / No m de f am ille First N am e(s) / P r é n o m ( s )
1
2
Male
Homme
Female
Femme
G
B ir th / N a is s a n ce
y e a r / a nn é e
Month
moi
Day
Jour
G
Canadian Citizen
Citoyen canadien
Yes
oui
G
3
G
No
Non
4
Las t Nam e / No m de f am ille First N am e(s) / P r é n o m ( s )
1
2
Male
Homme
Female
Femme
G
G
B ir th / N a is s a n ce
y e a r / a nn é e
Month
moi
Canadian Citizen
Citoyen canadien
Yes
oui
Sc hoo l lease in effec t?
Procuration scolaire signée?
Indica te
Cocher ( T)
Day
Jour
Indicate (T)
area
occupied.
Cocher
les parties
occupées:
G
G
*
This application is:
Cette demande est:
G
Approved
Approuvée
D ate / D a te
Day
Jour
G
3
G
No
Non
Roman
Catholic?
French-language
Education Rights?
catholique?
Droit à
l’enseignement en
langue
française?
3. Els ew he re In th is
m unic ipality
ailleurs dan s ce tte
mu nicipa lité
1. E ng lish- Pu blic
Public de langue anglaise
2. En glish-S epa rate
Séparé de langue anglaise
3. Fr en ch -Pu blic
Public de langue française
4. Fren ch-S epa rate
Séparé de langue française
4
G
G
G
G
1
2
3
4
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
G
G
G
G
yes
oui
G
yes
oui
G
no
non
G
no
non
G
1
2
3
4
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
yes
oui
G
yes
oui
G
no
non
G
no
non
G
1
2
3
4
yes
oui
G
yes
oui
G
no
non
G
no
non
G
1
2
3
4
yes
oui
G
yes
oui
G
no
non
G
no
non
G
1
2
3
4
yes
oui
G
yes
oui
G
no
non
G
no
non
G
1
2
3
4
Whole House
Maison entière
Base. Apt.
App. Au sous-sol
1st Floor
1er. étage
2nd Floor
2e. étage
3rd Floor
3e étage
G
G
G
G
G
Na m e of S cho ol Bo ard / A gen t / Nom du conseil scolaire/agent
Signature of Owner or Tenant
Signature du propriétaire ou du locataire
2. Els ew he re o n this
prop erty
ailleurs sur ce tte
prop riété
Su ppo rter/Ele ctor for:
Co ntribua ble/éle cteu r
des écoles:
4. In ano ther m unic ipality
dan s un e au tre
mu nicipa lité
List all occupants, including ALL children.
I n s c ri v ez le n o m d e t o us l e s oc c u p a n ts , ,y c o m p r is T O U S l e s e n fa n t s .
Las t Nam e / No m de f am ille
Sch ool Sup port (see instructions)
Sou tien sc olaire (voir les instructions)
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
Owner or tenant of this property since
Propriétaire ou locataire de le
propriété depuis
Date / Da te
Year
An né e
Mont h
M ois
Day
J o ur
Is here by authorized to act as agent in matters of school support designation in respect to the above mentioned
prop erty(ies) o n be half of th e un ders igne d. I est autorisé par le présente à agir en tant au’agent pour les questions
relatives à l’affectation des taxes scolaires en ce qui concerne le(les) propriété(s) mentionnée(s) ci-dessus au nom du
(de la) s ous sign é(e).
Month
Mois
Refused
Rejetée
Year
Année
Signature of Owner or Tenant
Signature du propriétaire ou du locataire
Date / Da te
Year
Année
Mon t h
Mois
Day
Jour
Signature of Assessment Commissioner
Signature du commissaire à l’évaluation
Date / Da te
Year
Année
Mon t h
Mois
Day
Jour
Reason for Refused /
Motif du refus
For School Board Use Only / Réservé au conseil scolaire
2 1 29 K (9 7 -1 2 ) W P M P A C
Information about the Application
The Application for Direction of School Support form enables any person to apply to have their school support included or revised on the assessment roll
by sending the completed form to the Regional Assessment Commissioner. The collection of the information on the form is authorized under the
Assessment Act and any personal information is confidential and protected under the Freedom of Information and Protection of Privacy Act.
The information will be used to direct your school taxes; to indicate whether you will be an elector for English-language or French-language school trustees;
to prepare voters’ lists for municipal and school board elections; to help with municipal and school board planning. Note: Tenants have the right to direct
school taxes even though they may not pay taxes directly.
Included below are instructions to help you complete each section of the form. If you have any questions about the form or about school support,
please contact your local Public or Separate school board.
HOW TO COMPLETE THE APPLICATION
A
Resident
Every person in your household should be listed. Put the family name first, followed by given name(s). Owner or tenants are listed first, followed by
spouses, all children, and other occupants. If this form is not for your permanent home (for example, if it is for your cottage or your business), only
owners, tenants and spouses should be listed - children and other occupants should not be listed.
B
Occupant’s Status
Is this person an owner, tenant, spouse, child, boarder or other resident? Note: A Roman Catholic who has signed a separate school lease will be
shown as a tenant. This does not affect their ownership.
C
School Support
Roman Catholic - includes Greek and Ukrainian Catholics
French-language Education Rights
You have French-language education rights if you are a Canadian Citizen and can answer “yes” to any one of the following questions:
1.
Is French the language you first learned and still understand?
2.
Did you receive your elementary school instruction in Canada in French? (This does not include French immersion or French as a second
language.)
3.
Have any of your children received, or are they now receiving, elementary or secondary school instruction in Canada in French? (This does not
include French imm ersion or French as a second language.)
School Board
Persons who are not Roman Catholic and do not have French-language rights, must be English-Public school supporters.
Persons who are not Roman Catholic but do have French-language education rights, must be either English-Public or French-Public school
supporters.
Roman Catholics who do not have French-language rights must be either English-Public or English-Separate school supporters.
Roman Catholics who have French-language education rights, have the choice of supporting any one of the following school boards: English-Public,
English-Separate, French-Public or French-Separate.
If you do not indicate which school board you support, it will be assum ed that you are an English-Public school supporter.
Renseignements sur La demande
La Demande d’affectation des taxes scolaires, dûment remplie et envoyé au commissaire régional à l’évaluation, permet à quiconque de demander de
préciser ou modifier son soutien scolaire sur le rôle d’évaluation. Ces renseignements sont recueillis en vertu de la Loi sur l’évaluation foncière et toute
information personnelle sera tenue strictement confidentielle et protégée par la Loi sur l’accès à l’information et la protection de la vie privée.
Ces renseignements serviront à déterminer la destination de vos taxes scolaires; à préparer les listes électorales aux fins des élections municipales et
scolaires; à faciliter la planification scolaire et municipale. Nota: Même s’ils n’acquittent pas directement leurs taxes scolaires, les locataires ont le droit d’en
choisir l’affectation.
Voici quelques directives qui vous aideront à remplir chacune des sections du form ulaire. Si vous avez des questions concernant le formulaire ou le
soutien scolaire, adressez-vous au conseil d’écoles publiques ou séparées de votre localité.
Comment remplir la demande
A
Résident(e)
Chaque occupant doit être recensé: le nom de fam ille d’abord, suivi de tous les prénoms; assurez-vous aussi que le sexe, la date de naissance et la
citoyenneté de chaque personne sont bien inscrits. Les noms de famille inscrits en premier sur la liste doivent être ceux des propriétaires ou
locataires, suivis de ceux du conjoint, de tous les enfants et de tout autre occupant de la propriétaire Si le formulaire ne concerne pas votre domicile
permanent (un chalet ou un bureau par exemple), seuls les noms du propriétaire ou du locataire et du conjoint doivent figurer sur la liste. N’inscrivez
pas les enfants et autres occupants.
B
Statut De l’occupant(e)
La personne est-elle: propriétaire, locataire, conjoint, enfant, pensionnaire ou autre? Nota: Un(e) propriétaire catholique qui a signé un <<bail d’école
séparée>>, sera classifié(e) comme <<locataire>>. Cela ne modifie aucunement le statut de propriétaire de cette personne.
C
Soutien scolaire
Catholique - comprennent aussi les catholiques grecs ou ukrainiens
Droit à l’enseignement en langue française
Vous avez droit à l’enseignem ent en langue française si vous êtes citoyen(ne) canadien(ne) et que vous pouvez répondre <<oui >> à n’im porte
laquelle des questions suivantes:
1.
Le français est-il la première langue que vous avez apprise et le comprenez-vous toujours?
2.
Avez-vous fait vos études primaires en français au Canada? (Cela n’inclut pas les program mes d’imm ersion ou de français langue seconde.)
3.
Avez-vous un ou des enfants qui ont fait ou qui font des études primaires ou secondaires en français au Canada?(Cela n’inclut pas les
program mes d’imm ersion ou de français langue seconde.)
Conseil Scolaire
Toute personne d’allégeance non catholique et qui ne jouit pas du droit à l’enseignement en français doit destiner ses taxes scolaires à un conseil
d’écoles publiques de langue anglaise.
Toute personne d’allégeance non catholique mais qui jouit du droit à l’enseignem ent en française doit destiner ses taxes scolaires à un conseil
d’écoles publiques de langue anglaise ou française.
Les catholiques qui ne jouissent pas du droit à l’enseignement en français doivent destiner leur taxes scolaires soit à un conseil d’écoles publiques de
langue anglaise, soit à un conseil d’écoles séparées de langue anglaise.
Les catholiques qui jouissent du droit à l’enseignement en française ont le choix de destiner leurs taxes scolaires à l’un ou l’autre des conseils
scolaires, à savoir écoles publiques de langue anglaise, écoles séparées de langue anglaise, écoles publiques de langue française ou écoles
séparées de langue française.
Si vous ne confirmez pas votre préférence en matière de soutien scolaire, vos taxes scolaires seront destinée au conseil d’écoles publiques de
langue anglaise.
( R ) 2 1 29 K (9 7 -1 2 ) W P M P A C
Durham District School Board
400 Taunton Road East
Whitby, Ontario L1R 2K6
Ph: 905-666-5500
1-800-265-3968
TTY: 905-666-6943
Fax: 905-666-6474
www.ddsb.ca
Dear Parent/Guardian and Student:
The Durham District School Board is pleased to provide parents/guardians and students with information
regarding computing and information technology facilities and resources available to students at school. Please
read this letter and the accompanying Acceptable and Safe Use Procedure.
DDSB computing and information technology facilities and resources are made available to students to support
their learning, research requirements, and career preparation. Such facilities and resources may include
computers and associated peripherals, the communication infrastructure and related equipment including local
area networks (LANs) and wide area networks (WANs), facsimile machines, scanners, copiers, telephone, video,
and other multimedia devices and forms of software.
DDSB services and technologies are expanding to allow all schools to offer Internet access to their students. The
Internet is a vehicle for accessing a global network of information resources. It provides valuable information and
interaction unavailable elsewhere.
Students may use this service to locate and retrieve information and communicate with others. With access to
Internet resources from all over the world comes the availability of material that may be questionable,
objectionable, or illegal, or contact with persons who may exhibit unacceptable behaviour. The DDSB provides
Internet access to students and staff through IBM’s NetVista which utilizes Cyber Patrol filtering software. This
software blocks access to specific sites known to contain violence, sexually explicit acts, intolerant, racist, and
other extremist viewpoints, cults, etc. No software is capable of blocking all unacceptable Internet sites.
However, the Internet is a leading technology in the delivery of information in today’s society and therefore, an
integral part of our student’s education.
Teachers and students are instructed on the safe and acceptable use of the Internet and other DDSB computing
and information technology facilities and resources. Teachers will supervise student use of the Internet as they
supervise student use of all other school resources.
All students are expected to abide by the DDSB Acceptable and Safe Use Procedure included with this letter.
Misuse and/or abuse of the facilities and resources are subject to consequences as defined and explained in their
school’s Student Code of Behaviour. In addition, use of the Internet is governed by Regulation 5500, the Durham
District School Board Code of Conduct, which states that “a student may be suspended or expelled from his or her
school, expelled from attending any school in Ontario, and/or prohibited from engaging in school-related
activities if the student commits an infraction of the Code of Conduct while he or she is at school, engaged in a
school-related activity, or engaged in conduct that has a relationship to the school, school community, the
reputation of the school or Board.” In addition, use is governed by all relevant federal (e.g., Copyright),
provincial (e.g., Education Act), DDSB (Policies and Procedures), and local school (e.g., School Code of
Behaviour) laws and regulations. Use of DDSB computing and information technology facilities and resources
for illegal, political, or private commercial purposes is strictly prohibited. The onus is on the user to know and to
comply with these laws and regulations.
We look forward to providing students with the opportunity to use the school’s computing and information
technology facilities and resources in a safe and meaningful way.
Acceptable and Safe Use Procedure
for computing and information technology facilities and resources
















Students must complete the attached Computing and Information Technology Facilities and Resources
Acceptable and Safe Use Procedure: Parental Consent Form. Students who do not complete this form,
which also acknowledges they have read and will abide by the code of conduct, will not have access to
computers within the school.
Applies to the use of all computer resources, including use of the Internet. Students are expected to
adhere to the hardware, software, and Internet Policies of the Durham District School Board and the
school.
Students are encouraged to use the computers and technology systems available at school for the express
purpose of academic achievement. Computer resources are to be used only for the purposes of schoolrelated activities and are not to be used for commercial or non-school related activities.
Students accessing material obtained from any source will not plagiarize this material in any school
assignment or project, or aid other students in plagiarizing material.
Students will not access, send, print, or distribute inappropriate material. Examples of inappropriate
material include, but are not limited to, the following:
- Content which is sexual, pornographic, racist, violent, satanic, militant, or extremist;
- Material depicting illegal activities, drug and drug culture, cults, gambling, betting, MUDS, or
violent games;
- Fraudulent, harassing, or obscene messages or materials. Chain letters and other forms of mass
mailings are not permitted;
- Contents deemed inappropriate by school administration.
Students will not be allowed to access chat groups, chat lines or Usenet News Groups. Games, other than
those approved and installed by Board personnel, are not permitted.
Students are responsible for proper password protection and a student may only use the account assigned
to them. Frequent changing of one’s password is encouraged.
Students will not attempt to circumvent data protection schemes or uncover security loopholes.
Students will not violate terms of applicable software licensing agreements and copyright laws.
Students will not knowingly run or install on any computer system or network, (or give to another
person), a program intended to damage or to place excessive load on a computer system or network. This
includes their home address, telephone number, picture, route taken to school, parent’s hours of work, etc.
Students will inform the teacher immediately when accidental access to inappropriate materials, or with
unacceptable users, has been made.
Students will assume that all communications distributed on the system are private and confidential and
will not disseminate them without permission from the original author.
Students will report all instances of hardware damage or changes to the Windows desktop or operating
system immediately.
Student files and folders will be monitored by the site administrator.
Students may lose computer privileges at school
Possible suspension, possible expulsion, based on the seriousness of the offence
Parents will be informed of serious technology infractions and resulting consequences
Computing and Information Technology Facilities and Resources
Acceptable and Safe Use Procedure: Parental Consent Form
PLEASE NOTE: The completion and return of this form is
required for student access to our computer/technology system.
I have read the “Acceptable and Safe Use Procedure for Computing and Information Technology
Facilities and Resources” and the accompanying letter to Parents/Guardians and Students. I understand
that if I do not follow the rules and procedures outlined therein, my access to computing and information
technology facilities and resources may be terminated.
Student #: _______________________________
Homeroom: ______
Homeroom Teacher: _________________________
Student Name: _________________________________________________
Student Signature: _______________________________
Date: _______________________________
Parent/Guardian Signature: _______________________________
Date: _______________________________
This form must be returned to your homeroom teacher as soon as possible after the beginning of classes.
Computer privileges will be temporarily permitted but will be withdrawn after a grace period if the form
has not been received.
Durham District School Board Voluntary,
Confidential First Nation, Métis and
Inuit Student Self-Identification Form
(DDSB Policy #4105)
To be completed by parents/guardians or students who are 18 and over.
Return this completed form to the school office.
Please print
The word Aboriginal is a collective term which refers to
all original people in North America. The Canadian
Constitution recognizes three groups of Aboriginal people:
First Nation is used to describe the various Nations of
Indigenous peoples of Canada who are not Métis or Inuit.
The term “First Nation” also has been adapted to replace
the word “band” in the names of communities.
First Name
Métis are distinct people with a unique history,
culture and language. The Métis history and culture
draws on diverse ancestral origins such as Scottish,
Irish, French, Anishnaabe, and Cree.
Last Name
/
/
Date of Birth (YY/MM/DD)
School
Current Grade
Please identify yourself as:

Definitions
First Nation
(Status/Non-Status)

Métis

An Inuit person is known as an Inuk. Inuktitut means
“the people”. Aboriginal people in Northern Canada,
who have lived in Nunavut, Northwest Territories,
Northern Quebec and Northern Labrador.
Inuit
Please indicate ancestry(optional):
COURAGE • EMPATHY • HONESTY • INTEGRITY • KINDNESS • OPTIMISM • PERSEVERANCE • RESPECT • RESPONSIBILITY • TEAMWORK
HONESTY • LOVE • HUMILITY • WISDOM • COURAGE/BRAVERY • RESPECT • TRUTH
COURAGE • EMPATHY • HONESTY • INTEGRITY • KINDNESS • OPTIMISM • PERSEVERANCE • RESPECT • RESPONSIBILITY • TEAMWORK
Parent/Guardian Signature
Date
For more information, please contact:
Durham District School Board at 905-666-5500 or visit the
Durham District School Board Aboriginal Education website
at www.ddsb.ca/programs/aboriginaled
www.ddsb.ca
Voluntary, Confidential First Nation, Métis and Inuit
Self-Identification Process Guide
What is First Nation,
Métis and Inuit Student
Self-Identification?
Promoting Success
for All First Nation, Métis
and Inuit Students
Self-Identification is the voluntary, confidential declaration of
ancestry as First Nation, Métis, or Inuit, of North America.
The Ministry of Education developed the Ontario First
Nation, Métis and Inuit Education Policy Framework, 2007
and Implementation Plan, 2014 which outlines the strategies
to be used to increase educational outcomes for students
of First Nation, Métis and Inuit ancestry.
Voluntary: The choice to self-identify a student’s First
Nation, Métis, or Inuit ancestry is up to you and does not
require proof of documentation (status card).
Communication: Self-Identification allows for direct
communication between schools, the Aboriginal Education
Department, First Nation, Métis, or Inuit students and their
families. This improves everyone’s ability to be informed
of student needs, programs and resources.
How do I Self-Identify?
Check off the First Nation, Métis and Inuit box on
page 1 of the Registration Verification Form or fill in
the form attached.
The DDSB has made a commitment to provide
First Nation, Métis and Inuit students with a culturally
supportive learning environment. Students will be invited
to participate in current and future programs dedicated
to educational and cultural growth.
No. The large majority of Durham’s Aboriginal residents
live in the Region’s major urban areas. You do not have
to live on a First Nation to self-identify your ancestry.
Why should I Self-Identify?
Self-Identification enables schools to support First Nation,
Métis, or Inuit students.
Measuring Progress: In order to measure the success
of these programs, it is important to know where the
First Nation, Métis, or Inuit students are and how well they
are doing in school.
1. Why should parents/guardians or students take part in the
Voluntary, Confidential Student Self-Identification process?
2. Is Voluntary, Confidential Self-Identification only for
students who live on a First Nation?
Confidential: Self-identification information is securely
stored and used only to support First Nation, Métis, or Inuit
student success.
Student Success: Programs, training and resources can
be directed where the needs are identified to support
First Nation, Métis, or Inuit student success.
Frequently Asked Questions
3. Is Voluntary, Confidential Self-Identification only for
Status Indians?
This is the traditional territory of
the Mississaugas of Scugog Island
First Nation.
8,905 people in Durham identified
as Aboriginal.
(2011 National Household Survey)
890 DDSB students have self-identified
their First Nation, Métis or Inuit ancestry.
(October 2014 ONSIS)
No. The goal is to self-identify First Nation, Métis and Inuit
ancestry. If you have any degree of First Nation (Cree,
Ojibway, Mohawk, etc.), Métis or Inuit ancestry then the
student would self-identify as having Aboriginal ancestry
and indicate First Nation, Métis or Inuit. You do not need
a Status card to self-identify your Aboriginal ancestry.
4. How will the Board use the information that is gathered?
Will the information be made available to the public?
The information will be used to develop and monitor
programs and strategies to improve your child’s
engagement, achievement and success. Regular reports
will be submitted to the Ministry of Education.
Information on individual students will not
be released.