Wellington Catholic District School Board - Dual Credit Application Form
(For the 2018/2019 school year)

Please complete the questions below. Once you hit submit, you will need to return to the Dual Credit website https://goo.gl/besosj, and:

1. print off the DC Consent form and have it signed by your parent/guardian (if under 18 yrs of age) and yourself.

2. print off and complete the appropriate college registration form

Note: Your Dual Credit application will only be complete once these two forms have been completed, the necessary signatures obtained and both handed in to your guidance counsellor.
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Applicant Information
Salutation *
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Email *
(email that you will check regularly - NOT wellingtoncdsb.ca email)
Cell Number *
(555-555-5555) NOTE: If you don't have access to a cell,  please include your home # or a parent's cell # if possible.
Are you a Specialized High Skills Major Student? *
Are you in OYAP (Ontario Youth Apprenticeship Program)? *
Do you have a current Individualized Education Plan? (IEP) *
Do you have a medical or diagnostic condition? *
Address Information
Street Name *
Unit #
(if applicable)
City *
Postal Code *
Emergency Contact Information
First Name *
Last Name *
Relationship *
Cell Phone *
(555-555-5555)
High School Information
School *
Current Grade Attending *
OEN Number *
Select the Dual Credit Program that you wish to apply for:
(Detailed Program Descriptions can be found here at http://www.wellingtoncdsb.ca/Programs/Pathways/DualCredit/Pages/default.aspx)
Conestoga College (Semester 1 only)
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Conestoga College (Semester 2 only)
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Submit
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