ARC (APSEA Recreation Club)

ARC (APSEA Recreation Club)
Online learning programs for children and youth are designed for students who qualify for APSEA services and registration must be completed by the student's APSEA Educational Support Teacher (EST) / itinerant teacher.
EST / Itinerant Teacher Name:*

First NameLast Name
EST / Itinerant Teacher Email Address:*
example@example.com
Student Information
Student Name:*

First NameLast Name
Grade:*
If Other, please specify grade:*
City/Town:*
Province:*
Student Email Address:
example@example.com
Parent/Guardian Information
Parent/Guardian Name:*

First NameLast Name
Parent/Guardian Email Address:*
example@example.com
School Information
School District/Regional Centre for Education*
School Name:*
School Team Contact Name:*
School Team Email Address:*
example@example.com
School Team Member Role:*
If Other, please specify:*
In Class Support
Full Name:

First NameLast Name
Email Address:
example@example.com
Job Title:
If Other, Please Specify:*
Informed Consent for Student Participation for Online Programs:*

Uploaded to the APSEA Database
Permission to Record or Photograph:*

Uploaded to the APSEA Database
Level of permission to record or photograph:*
Note: By completing this registration you are agreeing that the applicable required permission forms have been uploaded to the APSEA database.
Feedback
How did you hear about this program?*
If Other for how you found out about this program, please specify
Should be Empty:

Student Information