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Home
About Us
Programs
Grade 9
Grade 9 Mathematics
Grade 9 French Language
Grade 9 English Language
Grade 10
Grade 10 Mathematics
Grade 10 English Language
Grade 10 French Language
Grade 11
Grade 11 Mathematics
Grade 11 English Language
Grade 11 French Language
Admissions
Blog/Resources
Contact Us
Course Enrolment Form
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Course Enrolment Form
Student First Name
*
Student Preferred Name (Optional)
Outline the preferred name if it is different than the first name
Last Name
*
Student Gender
*
Male
Female
Prefer not to say
Other
Student Date of Birth
*
Student Personal Email Address
*
What is your child's most recent grade in mathematics?
*
Please provide your child's most recent grade in mathematics in the form of a percentage.
Which course are you applying to?
*
Choose
MTH1W - Grade 9 Math
MPM2D - Grade 10 Math
MCR3U - Grade 11 Functions (University)
MHF4U - Grade 12
MCV4U - Grade 12
Which session are you signing up for?
*
Choose
Summer 2024
Fall 2024 - Semester 1 (October - January)
Winter 2025 - Semester 2 (February - May)
Does your child have access to a laptop or a Chromebook?
*
Yes
No
Please note that it is highly recommended for students to have access to an electronic device for this course to engage in activities.
OEN#
*
Please note: An OEN (Ontario Education Number) is NOT the same as the student number. The OEN is a 9 digit number that can be found on your child's timetable, past report cards, and/or credit counselling summary. The OEN is mandatory to process the credits earned.
Street Address
*
Unit/Apartment # (Optional)
City
*
Province
*
Postal Code
*
Do not include spaces (i.e.: A1B2C3)
How did you hear about us?
*
Choose
Google
Facebook
Linkedin
Instagram
Word of Mouth
Referral
Other
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Parent/Guardian Email Address
*
Alternate Email Address (Optional)
Parent/Guardian Phone Number
*
Secondary Phone Number (Optional)
Preferred Method of Contact
*
Email
Phone
Which grade is your child currently in?
*
Choose
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Credit Counselling Summary
Choose File
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Please ask your child's guidance counselor for a credit counselling summary to ensure that the appropriate pre-requisites for this course have been completed. If you need help, please contact your child's school or send us an email at info@rootstoroutes.ca.
Does your child have an IEP (Individualized Education Plan)?
*
Yes
No
Current School Board
*
Your current is the school that your child is attending now. This is the school your child attended from September 2023 to June 2024.
Current School Name
*
School Street Address
*
School City
*
School Province
*
School Postal Code
*
Do not include spaces (i.e.: A1B2C3)
Current Guidance Counsellor Name
*
Current Guidance Counsellor Email
*
Will your child be attending a new school in September?
*
Yes
Maybe
No
Note: All grade 8 students entering grade 9 in September must select "Yes".
Which high school will your child be attending in September? Please list all potential high schools below.
*
A new high school is the school that your child will be attending in September. This is the school your child will be attending for the first time in September 2024.
Does your child/ward take prescribed medication on a regular basis?
*
Yes
No
Will your child/ward take prescribed medication(s) with them during the program?
*
Yes
No
Does your child/ward wear or carry medical alert identification (e.g. bracelet)?
*
Yes
No
Does your child/ward need an EpiPen?
*
Yes
No
Does your child/ward need an asthma inhaler?
*
Yes
No
Are there any significant medical conditions, physical limitations, or any other concerns that might affect your child's/ward's full participation in the course?
*
No
Other
Please specify them here.
Should it become necessary for my child/ward to have medical care, I hereby give the teacher permission to use their professional judgement in obtaining the best of such service for my child/ward. I also understand that in the event of such illness or accident, I will be notified as soon as possible.
*
I understand and accept these terms.
Does your child/ward have any allergies and/or dietary restrictions?
*
Yes
No
By checking this box, I hereby confirm that all of the information provided in this form is accurate and provide consent to Roots to Routes Academy Inc. to use the information provided for the purpose of this course.
*
I agree with the above statement.
By checking this box, I hereby confirm that the high school credit will only be given if the student completes a minimum of 110 hours and obtains above a passing grade as outlined by the teacher. Three unexplained absences may lead the child subject to being removed from the course. The child's school(s) is responsible for granting the credit and reserves the right to refuse or deny the credit obtained.
*
I acknowledge with the above statement.
Submit
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