THE HAMILTON-WENTWORTH DISTRICT SCHOOL BOARD

SALTFLEET DISTRICT HIGH SCHOOL -- GRADE 9 COURSE SELECTION SHEET 2017-2018

Elementary School
Student
Last Name First Name
Male _____ Date of Birth ______/______/______Home Phone # ( ) ______
Female _____ day month year
Legal Address
Number and Street Name
Email Address
City/Town Postal Code
Mother/Guardian
Last Name First Name Work Phone #
Father/Guardian
Last Name First Name Work Phone #
Student’s Identified Exceptional Yes _____ No _____
Health Card # Receiving Resource Assistance Yes _____ No _____

Elementary School Teacher Recommendations:

English / o Locally Developed / o Applied / o Academic / o Enhanced
Mathematics / o Locally Developed / o Applied / o Academic / o Enhanced
Science / o Locally Developed / o Applied / o Academic
French / o Open / o Applied / o Academic
Geography / o Applied / o Academic
Support Program / o Math Support Class / o Bump Up Math Class / o Empower Class

1.Students must choose ONE from each of the following six courses. Please note you will choose either Female or Male physical education. Be sure to check the teacher recommendations above to ensure that you are choosing the appropriate course for success-changes are NOT easily made.

English / o ENG1L1 Locally Developed / o ENG1P1 Applied / o ENG1D1 Academic / o ENG1D1E Enhanced
Mathematics / o MAT1L1 Locally Developed / o MFM1P1 Applied / o MPM1D1 Academic / o MPM1D1E Enhanced
Science / o SNC1L1 Locally Developed / o SNC1P1 Applied / o SNC1D1 Academic
French / o FSF1O1 Open / o FSF1P1 Applied / o FSF1D1 Academic
Geography / o CGC1P1 Applied / o CGC1D1 Academic
Phys. Ed.
F – Female
M – Male / o PPL1O1F
o PPL1O1M

2.Students must choose TWO of the following courses: ONE from each box.

Dramatic Arts Instrumental Music
□ ADA1O1 □ AMU1O1
Visual Arts Music – Enhanced
□ AVI1O1 □ AMU1O1E / Introduction to Information Technology in Business
□ BTT1O1
Food and Nutrition Exploring Technologies
□ HFN1O1 □ TIJ1O1

MEDICAL INFORMATION

Please check off any life threatening conditions, physical limitations or any other concerns which might affect the student.

□ Epilepsy / □ Fainting Spells / □ Ear, Nose, Throat Infections
□ Diabetes / □ Digestive Upsets / □ Hemophilia
□ Migraine Headaches / □ Nosebleeds / □ Asthma
□ Medic Alert Identification
Medic Alert for:
______/ □ Other:
______/ □ Allergy
□ Food ______
□ insect stings ______
□ drugs ______
Does the student have an asthma inhaler? Yes □ No □
Does the student have an EPIPEN? Yes □ No □

Please include the following with this Option Sheet:

□ a copy of the most recent report card

□ a copy of the most recent Individual Education Plan (IEP) if the student is receiving special education/resource room assistance

□ a student fee with cheque payable to Saltfleet High School

□ $20 – student fee

□ $50 – student fee and yearbook

Option Sheets must be submitted to Saltfleet District High School

no later than Friday, February 17, 2017

Elementary Principal’s Comments and Signature:

PLEASE TURN OVER