2016-2017 PROGRAM APPLICATION PACKAGE Revised September 2016 Submit to your Secondary School Career Education Contact or Coordinator
SOUTH ISLAND PARTNERSHIP PROGRAM APPLICATION INFORMATION GETTING STARTED Students and parents meet with a school career coordinator/counsellor to discuss SIP program options. Visit our website: camosun.ca/learn/south-island-partnership. Questions can be directed to your school career coordinator/counsellor or the SIP office (250-370-4827, email SIP@camosun.bc.ca). Important: college course(s) will be recorded on your permanent post-secondary file. Careful consideration is to be made when deciding to take a post-secondary program. Students should not take a post-secondary program unless they are prepared to attend all classes and complete all assignments. Withdrawal Process: Students wishing to withdraw from a program must first contact the SIP Office immediately. Individual Education Plan (IEP): Students with a learning condition or other disability which may require additional support services should make an appointment with the Disability Resource Centre (250-370-4049). HOW TO APPLY (please complete all forms in ink) See your school career coordinator/counsellor for assistance completing this package. ACE IT trades students will also fill out an Industry Training Authority (ITA) Apprentice/Sponsor registration form. Return the completed application package to your school career coordinator/counsellor for submission to: SIP Office, Camosun College, Jack White Building Room 105C, 4461 Interurban Road, Victoria, BC V9E 2C1 or via Fax: 250-370-3723 (only when payment is made with a credit card). Sample the Campus applications are supplied by April Atkins (AtkinsA@camosun.bc.ca; 250-370-4827). Students are accepted based on meeting qualifications and date of application received in the SIP office. Students will be notified if qualified and accepted into the program. Program applicants will be required to attend an orientation. ACE IT (trades) students may be required to complete an assessment. Where applicants exceed availability, a waitlist may be established. APPLICATION SUBMISSION CHECKLIST (please complete all forms in ink) Completed SIP Application Form, including ALL signatures Application Fee (via credit card or cheque made payable to Camosun College) *non-refundable Signed Permission to Release Information Form (a College requirement) Completed and signed Responsibility Agreement AND Student Statement of Commitment forms Completed and signed Student Education/Transition Plan Transcript of marks for the last completed year, including grades ten and eleven Teacher Recommendation Form or Attendance Record Evidence of 30-hour related Work Experience Completed and signed Sponsorship Form, where applicable English & Math Assessments, where applicable NOTES: Incomplete applications will be returned to the high school, unprocessed. Tuition fees will be paid by your school district. You are responsible for the non-refundable application fee, textbooks, equipment, supplies, and clothing. Fees may change without notice. DUAL CREDIT PROCESS Students will receive high school credits and marks on their high school transcript. Students will also receive college credit for the program. Apply for a college transcript to receive your report. http://camosun.ca/services/_documents/transcript-request.pdf Program Acceptance Disclaimer: These programs may not be governed by Camosun College s policies on admission and academic progress and promotion.
South Island Partnership Camosun College 4461 Interurban Road Victoria BC V9E 2C1 250-370-4208 SIP@camosun.ca PERSONAL INFORMATION (please print clearly) Have you applied to or attended Camosun College before? Yes No If yes, what is your Camosun College Student Number? SOUTH ISLAND PARTNERSHIP APPLICATION FORM C _ LEGAL LAST NAME FORMER LAST NAME (if applicable) LEGAL FIRST NAME PREFERRED FIRST NAME (if applicable) MIDDLE NAME(S) Check if you have none CITIZENSHIP STATUS Canadian If you are not a citizen of Canada, please select your official status in Canada (documentation required): Permanent Resident/Landed Immigrant, provide copy of card front and back: Other Visa or Permit, provide copy of passport picture and Study Permit: DATE OF BIRTH M M D D Y Y Y Y / GENDER Male Female SOCIAL INSURANCE NUMBER (optional*) - - *Providing your SIN helps us to ensure the accuracy and completeness of your transcript and your tuition tax receipt. CONTACT INFORMATION MAILING ADDRESS CITY PROVINCE POSTAL CODE STUDENT HOME TELEPHONE NUMBER - - PARENT/GUARDIAN NAME STUDENT CELL PHONE NUMBER - - PARENT/GUARDIAN PHONE NUMBER - - STUDENT EMAIL PARENT EMAIL EMERGENCY CONTACT NAME RELATIONSHIP TO STUDENT EMERGENCY CONTACT PHONE NUMBER - - PROGRAM CHOICE (A collection of courses that usually leads to a credential, such as Welding or HCA) PROGRAM (full-time) PROGRAM LOCATION PREFERRED START DATE ACE IT Apprenticeship ACE IT Foundation COURSE CHOICE (A course covers one subject, such as Math 100 or Engl 151. Include section #) COURSE COURSE LOCATION COURSE START DATE COURSE COURSE LOCATION COURSE START DATE COURSE COURSE LOCATION COURSE START DATE COURSE COURSE LOCATION COURSE START DATE SECONDARY SCHOOL (HIGH SCHOOL) INFORMATION BC Personal Education Number (PEN) if known GRADE CURRENTLY ENROLLED IN EXPECTED GRADUATION DATE SECONDARY SCHOOL NAME SD # TEACHER / COUNSELLOR NAME (please print): DATE M M Y Y Y Y APPROVAL (signature):
TRANSCRIPTS 1. Submit up-to-date high school grade information (unofficial transcript) with this application. 2. To request transfer credit assessment at Camosun College for course(s) taken at another institution to meet prerequisite requirements or credential requirements, you must submit official transcripts. When submitting official paper transcripts, they must be in an envelope sealed by the sending secondary school (high school). For dated and out-of-province transcripts, you may be required to submit official course outlines. Official transcripts from out-of-country must be accompanied by official course outlines (if in languages other than English, you must include official translations into English). ACCEPTANCE TO A PROGRAM All program applicants will participate in an orientation prior to acceptance to a program. Acceptance is subject to seat availability, completion of prerequisites, and work experience. Application fees are processed upon acceptance into a program. This does not apply to course applications. VOLUNTARY DISCLOSURE By completing this section, you indicate you understand that you may be contacted by the school, based on the information you provide (extra college services may be available). Are you of Aboriginal ancestry? (First Nations, Mėtis or Inuit) Yes No If Yes, are you First Nations Status First Nations Non-Status Inuit Metis Do you have an Individual Education Plan (IEP), a learning condition or other disability for which you may require additional support services? Yes No If Yes, your next step is to make an appointment with the Disability Resource Centre www.camosun.ca/drc 250-370-4049 WITHDRAWAL POLICY To receive full tuition refund, you must withdraw within two weeks of the start of class. To avoid a permanent academic record for low achievement, students may withdraw from a course prior to the withdrawal deadline. The deadline to withdraw without academic penalty falls after completion of 66% of the academic term. For all withdraws or for more information, contact the South Island Partnership office. DECLARATION The personal information on this form and other personal information which forms part of your student record is collected under the legal authority of College and Institutes Act, [RSBC 1996] c.52, and the Freedom of Information and Protection of Privacy Act [RSBC1996] c. 165. The information is used for administrative and statistical research purposes of the College and/or the ministries or agencies of the Government of British Columbia and the Government of Canada. The information will be protected, used, and disclosed in compliance with those acts. Except as provided in the foregoing, the personal information collected on this form and other personal information which forms part of your student record will not be disclosed to any other person without your consent. A Permission to Release Information form, available from Student Services and camosun.ca, must be signed in order for Camosun College to provide access or release your personal information to any other person. However, Camosun College may be required to release a student s personal information if it becomes aware of compelling circumstances where there is a risk to the health and safety of the student or others. Please read the following before signing: 1. I declare that the information contained in this application is to the best of my knowledge complete and correct. 2. I agree to abide by the rules and regulations of the college. 3. I understand the application fee is non-refundable, is required from all applicants to a course, and that the application will not be processed until this fee is received. 4. I understand and agree that acceptance of this application in no way guarantees admission to the course and that this application is subject to the availability of seats. I understand and agree the college reserves the right to modify or cancel any course without notice or prejudice. Signature of Applicant Signature of Parent/Guardian Date Date FEES APPLICATION FEE - Payment is due with each application (non-refundable) (Cash will not be accepted) $40.20 Invoice School District Cheque or Money Order (attach) Payable to Camosun College Visa Mastercard American Express JCB Card No: Expiry / M M Y Y TUITION FEE (Credit card and cash will not be accepted) Invoiced by SIP Office (contact SIP office to confirm method) Secondary students completing an application to register in a college course are often sponsored by the school district. To confirm sponsorship eligibility, speak with your high school counsellor for details School to identify if a student is reported through DL Yes No External Sponsorship Form Name of Card Holder:
PERMISSION TO RELEASE INFORMATION AND AUTHORIZATION TO ACT ON MY BEHALF The British Columbia Freedom of Information and Protection of Privacy Act provides that the college may not release any information pertaining to student records to anyone other than the student owner of the record without the student s consent. Further, the college does not normally allow any person other than the student to conduct student-related business with the College on behalf of the student. In order to allow the South Island Partnership and your parent(s)/guardian(s) to conduct student-related business on your behalf, you must complete and submit this form as part of the SIP application package. Student Name: Last Name (please print) First Name (please print) Camosun Student #: C (Office Use Only) Date of Birth (mo/day/year): To the Enrolment Services Department: The following secondary school and Parent(s)/Guardian(s) (please print) have permission to access my student records and conduct student-related business on my behalf while I am registered in a South Island Partnership course/program. Student Signature: Date: Questions? South Island Partnership Phone 250-370-4208, Email SIP@camosun.bc.ca
RESPONSIBILITY AGREEMENT - PROGRAMS High School/School District, SIP, and Camosun Responsibilities We will: provide tuition funding for program training at Camosun College inform you of the training requirements specific to your career area and provide you with background information on requirements for Camosun College assist you to meet all prerequisites and create an Education/Transition Plan that maps your final years of high school help you to complete a SIP application package and submit it to SIP on your behalf register you as an ACE IT student (for trades programs only) provide you with student support services as needed (assessment, learning skills, English and/or math upgrading, counselling, disability resources) encourage you to be proactive in informing the Disability Resource Centre of specific learning needs and IEPs (make an appointment with our DRC by calling 250-370-4049) liaise with your parents, high schools teachers, and Camosun instructors regarding your college progress and participation provide post-secondary marks to your high school for graduation credits Student Responsibilities As a South Island Partnership student, I agree to: understand that punctuality and attendance are mandatory at Camosun contact my instructor and the SIP office (250-370-4826) immediately if I will be absent or late follow the Camosun College Student Conduct Policy (refer to http://www.camosun.bc.ca/learn/becoming/policies.html) respect that my home school Code of Conduct applies to all courses and programs respect, compliance, and effort are required at all times successfully meet all prerequisites before attending Camosun participate in a Math or English upgrading program/assessment if deemed necessary undergo a relevant work experience placement in my chosen program area submit a completed application package and the application fee to my high school career counsellor attend a SIP orientation when invited meet program homework and study expectations (2-4 hours daily) strive to achieve a passing mark of at least 70% in my program inform my Camosun instructor and my school career coordinators of withdrawal from my courses as soon as possible understand that failure to withdraw in advance of 66% of program completion may result in an F on both my high school and post-secondary transcripts; (withdrawal must occur before the final third of the course begins) be aware that if I require an extension, I will be responsible for both tuition and student ancillary fee payment understand that it is recommended that students attend after-session tutorials offered by the instructor purchase required text books, support materials, equipment, and clothing contact the SIP office should I need assistance (250-370-4827) Student Name (please print clearly): Student Signature: Date: Parent/Guardian Name (please print clearly): Parent/Guardian Signature: Date: Career Counsellor Name: High School:
STUDENT STATEMENT OF COMMITMENT Students applying to take a program must complete this form. Student Name: (please print clearly) Date: Describe why this is the career area for you. _ Describe how your work experience or school activities have prepared you for this program. _ Describe what you will do to be successful in this program. Student Signature: Date:
TEACHER RECOMMENDATION FORM Student Name: ACE IT Program Applying for: Teacher Name: Subject: (Related to Program applied for) Current letter grade: Absences _ Lates Please check the following traits as: Excellent Good Satisfactory Maturity Needs Improvement Ability to follow instructions Enthusiasm and interest Adaptable adjusts to new tasks Follows through on assigned tasks Attendance Punctuality Shows motivation to learn new skills Can work independently Has positive attitude towards work Accepts constructive criticism Please comment on the student s readiness for post-secondary learning Teacher Signature: Date: