HLC Pre-registration 2022-2023

Pre-registration for the 2022-2023 school year will open February 24th.

Most of our Heartwood Programs are full for this current year. If you are interested in enrolling, please contact Marieke Holtkamp (marieke.holtkamp@sd71.bc.ca).

HLC Pre-registration 2022-2023

"*" indicates required fields

Have your identification documents handy:

Valid Residency Proof: BC Care Card, BC ID Card, BC Driver's License, or current utility bill
Student's Valid Canadian Citizenship Proof: Birth Certificate, Passport, or Permanent Resident Card

Select your location:*

I confirm that I am choosing a blended learning program and will be participating in face-to-face contact days*

Yes

If you are not interested in a blended learning program, you might find Navigate's full-time K-9 program more suitable.

Student Information

Hidden

Start Date

September 2019

Other

Legal First Name*

Legal Middle Name*

Or 'None' if not applicable

Legal Last Name*

Usual Name

First Last

Date of Birth*

Gender*

Male

Female

Prefer to Self-Describe

Your preferred gender description:*

Are you of First Nations, Metis, Inuit Aboriginal ancestory?*

None

Status - On Reserve

Status - Off Reserve

Non Status

Metis

Inuit

Self-Identification

Self-identified means if a student (parent/guardian) identifies themselves as having Aboriginal ancestry then they qualify to receive service from Aborginal Education Services. No one is required to provide 'proof' of ancestry when they self declare (e.g. Status card.) Aboriginal ancestry can go back several generations and the student may not look Aboriginal.

Residency & Citizenship

You must be a resident of BC to register with Navigate-NIDES.

If you have any questions please contact us at 1-800-663-7925

Resident of British Columbia?*

Yes

IMPORTANT: If you are sending an image of your BC Driver's Licence and Services Card - please note that we only need an image of the FRONT of the card.

Proof of Residency Upload*

Acceptable proof of residency includes images of: BC Care Card, BC ID Card, BC Driver's License or current utility bill

Hidden

Proof of Residency Upload

Max. file size: 8 MB.

Acceptable proof of Residency includes images of: BC Care Card, BC ID Card, BC Driver's License, or current utility bill.

Citizenship Status*

Canadian Citizen

Landed Immigrant

Proof of Student's Canadian Citizenship Upload*

Acceptable proof of Canadian Citizenship: Birth Certificate, Passport, or Permanent Resident Card

Hidden

Proof of Student's Canadian Citizenship Upload

Max. file size: 8 MB.

Acceptable proof of Canadian Citizenship: Birth Certificate, Passport, or Permanent Resident Card

Contact Information

Primary language spoken in the home*

Home Phone:*

Home Address:*

Street Address Address Line 2 City Province Postal Code

My mailing address is...

the same as my home address

different from my home address

Mailing Address*

Street Address Address Line 2 City Province Postal Code

Guardian / Parent #1 Information

Name of Parent / Guardian #1*

First Last

Relationship To Student*

Is this guardian/parent's home address the same as the student home address?*

Yes, they live at the same address

No, it's a different address

Primary Address*

Street Address City Province Postal Code

Phone - Home*

Phone - Work*

Phone - Cell*

Parent/Guardian #1 Email*

Would you like to add a second Parent/Guardian?*

Yes

Guardian / Parent #2 Information

Name of Parent / Guardian #2*

First Last

Relationship To Student*

Is this guardian/parent's home address the same as the student home address?*

Yes, they live at the same address

No, it's a different address

Primary Address*

Street Address City Province Postal Code

Phone - Home*

Phone - Work*

Phone - Cell*

Parent/Guardian #2 Email*

Living Arrangements

The student lives with ____________*

Both Parents

Mother

Father

Other

Legal Alert*

Yes

Court Order*

Yes

Other special considerations or comments:

Emergency Contact

Emergency Contact #1 Name:*

First Last

Emergency Contact #1 Phone Number:*

Emergency Contact #1 Relationship to Student:*

Would you like to add a second Emergency Contact?*

Yes

Emergency Contact #2

Emergency Contact #2 Name:*

First Last

Emergency Contact #2 Phone Number:*

Emergency Contact #2 Relationship to Student:*

Medical Information

Student's Care Card #*

Any allergies or health conditions?*

(Enter 'none' if there are no allergies or health conditions)

Is it life threatening?*

Yes

Does your child require medication?*

Yes

Please indicate the medication and the procedure for administering it. For example - will someone at the school be required to assist with medication?*

Education

Has the student received learning assistance?*

Yes

Learning Assistance areas of focus

Has the student had an Individual Education Plan?*

Yes

I don't know

When was Individual Education Plan done?

Previous Education

Are you currently enrolled at navigate (NIDES)?*

Yes

Grade you are applying for:*

K-9 Full Time

Current Grade Level:*

Name of last school*

Reasons for withdrawal:*

(Enter 'none' if student was not at another school)

Location of last school:*

(Enter 'none' if student was not at another school)

Navigate-Nides will become my home school (School of Record)*

I understand

Permissions

We reserve the right to make changes to the following Permission Forms at any time. If we make any changes, we will update this website to include such changes. Such changes will be effective when posted.

Canadian Anti-Spam Legislation Consent

Canada’s anti-spam legislation came into force on July 01, 2014. As a result, School District No. 71 (Comox Valley) would like to ensure that we have your consent to send you newsletters, announcements and other electronic messages which may contain advertising or promotions including field trips, fundraising, yearbooks, student pictures, school activities, or similar events and offers that would be considered Commercial Electronic Messages under the legislation.

If you have any questions, please contact us at:

School District Information and Privacy Officer
Business Address:	607 Cumberland Road
	Courtenay, BC
	V9N 7G5
Telephone No.:	250-334-5500

You may withdraw your consent at any time by communicating directly with the school in writing. Failure to provide alternative consent, will mean you will not receive certain communications from the school or School Board Office that would be considered Commercial Electronic Messages.

Canadian Anti-Spam Legislation Consent*

I have read the above text and consent to receiving newsletters, announcements and other electronic messages from Navigate-NIDES and Comox Valley Schools

I do not consent

Google Apps for Education (GAFE) Permission

Link to the Google Apps for Education (GAFE) Permission Form

GAFE Consent:*

I agree to the collection, use, disclosure and storage of my child’s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above. I am aware of and understand the identifiable privacy risks as described above and will support the classroom teacher in minimizing the exposure of my child’s and other people’s personal information while my child is using the technology and review materials the teacher provides.

I do NOT agree to the collection, use, disclosure and storage of my child’s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above.

This consent is valid for the duration of the student’s enrollment at Navigate NIDES unless revoked by me in writing and delivered to the teacher.

Navigate-NIDES Code of Conduct

Link to the Code of Conduct

I have read the Code of Conduct and understand my child's responsibilities*

I agree

Technology Rights and Responsibilities

Link to the Technology Rights and Responsibilities

I have read the Technology Rights and Responsibilities document and understand my child's responsibilities*

I agree

School Emergency Program Guide

Link to the School Emergency Program Guide

I have read and understand the School Emergency Program Guide*

I agree

Outside Media Consent

I have read the information contained in the Outside Media Consent and understand that outside media may on occasion be authorized by the school to be present at the school, at school events or at public events where students are present. I understand that the School does not control the images or material printed by external media, and that it is my responsibility to communicate with the school if I have a concern about the collection of my child's image or information by external media that are authorized by the school to be present on school property or at school events.

Outside Media Consent response:*

Yes, I agree that my child's image may be published by outside media.

No, I do not authorize outside media to have access to my child or any information or images of my child for publication. (I understand my child will not be in the graduation insert in the newspaper - if applicable.)

Personal Information Consent

I have read the information contained in the Personal Information Consent and understand that outside media may on occasion collect photographs, video or electronic images of students or their work for publication on the School's website or in other publications for the purposes of recognizing student or school achievement, promoting school activities or events, or informing the school community and members of the public about school programs and activities.

Personal Information Consent response:*

Yes, I consent to the collection, use and disclosure of my child's image and work product for the purposes described above and in the Personal Information Consent.

No, I do consent to the use of my child's image or work product as described above.

Media & Website Consent of Storage & Access of Information

Media & Website Consent of Storage & Access of Information link

I have read and understand the Media & Website Consent of Storage & Access of Information*

I agree

User Confirmations

The Applicant confirms that the information in this form is accurate and complete, that the Applicant(s) have the legal right to enroll the student in Navigate (NIDES); and that enrollment remains valid for one year.*

I agree

The Applicant agrees to meet formally with the assigned Navigate (NIDES) teacher (face-to-face or virtually) to develop and sign a Student Learning Plan document for each student candidate.*

I agree

The Applicant confirms the legal guardian, student, and home facilitator’s commitments to working together with Navigate (NIDES) in completing the coursework agreed to by all parties during the normal academic calendar. Working together is defined by consistent and regular activity in the program of study, weekly submissions of student work according to the Student Learning Plan, and continuous communication with Navigate (NIDES) teachers on a weekly basis.*

I agree

The applicant understands that if the student becomes inactive and does not meet the goals and outcomes established in the Student Learning Plan, that he/she may be referred to enroll in a school program elsewhere.*

I agree

The Applicant hereby authorizes the release of all previous records to Navigate (NIDES), and authorizes Navigate (NIDES) to report to schools, school districts, or post-secondary institutions where records exist.*

I agree

The Applicant agrees that he/she will submit official documents that confirm BC Residency (i.e. digital copy of Care Card, Drivers License, or recent utility bill), as well as proof of official citizenship status (i.e. digital copy of Birth Certificate, Permanent Resident Card, or Visas) upon registration.*

I agree

The Applicant declares that the student and legal guardian are ordinarily resident in British Columbia, and if traveling outside of the province of BC, the Applicant will inform the registrar (registrar@sd71.bc.ca) in writing of their intended return date to British Columbia.*

I agree

By completing this form and submitting it, it is assumed that the Applicant agrees to the above conditions of enrollment.*

I agree

I consent to receive Aboriginal Student Support from Navigate.*

I agree

Questions/Comments

Parent or Guardian signature required*

*IMPORTANT* - Email Confirmation of Submission*

I am aware that I will receive an email confirmation within 15 minutes of submitting this form. If no confirmation arrives, then my registration was not received and I will need to resubmit. [Please check that it is not in your junk mail folder.]

Phone

This field is for validation purposes and should be left unchanged.