TISDALE MIDDLE & SECONDARY SCHOOL

North East School Division #200 Treaty 6 Territory Box 1000 800 101 Street Tisdale, Saskatchewan SOE ito Principal Mr. Terry Andrusiak Vice-Principal Mrs. Carmen Messer Vice-Principal Mr. David Painchaud Phone: (306) 873-2352 Fax: (306) 873-2941 tmss@nesd.ca determine if the student has enough prior music knowledge to be in the Band program. the student is in Grade 7-9, a conversation with the Band teacher may be necessary to LI If your child is in Grade 6-9, please let me know if your child would prefer Art or Band. If needed. LI If your child is 15 years old or older, please let the office know if Driver s Education is LI High school classes and Graduation Requirement information is available on the TMSS LI If your student is in grade 10-12, in order for the Academic Counsellor to plan your LI Fill out the Tisdale Community Library Registration Form. Parent signature is needed. o Signature of student ONLY if over 18 years old, otherwise, the parent MUST sign o Birthdate, Gender, Names webpage: http://www.nesd.ca/school/tmss/studentinfo/pages/registration.aspx. student s classes to ensure successful graduation, please fill out: Authorization for Guidance Counsellors to Access Student Information Form: LI Fill out the Registration Form. Please sign and have your student sign. Please note the following when registering with TMSS: Thank you for registering with Tisdale Middle & Secondary School and Welcome. 2019-2020 COMMIT TO GmR.I.4 TISDALE MIDDLE & SECONDARY SCHOOL

First Middle Name(s): STUDENT INFORMATION Legal Last Preferred Last (if differentfrom Legal) FORM Today s Date: Does this student have any other medical condition that we should be aware of? If yes, please explain: Does this student have a severe or life threatening medical condition: Q YES Q NO SK Hospitalization # Doctor s Name & Phone It: Phone/cell#(s) 2. Childcare provider: Phone/Cell #(s) 1. Emergency Contact EMERGENCY CONTACTS & MEDICAL INFORMATION (ifnot the same as the student) (ifnot the same as the student) Home Address: Home Address: Email: Email: communications: Q email Q paper communications: Q email Q paper such as newsletters. How would you like to receive these such as newsletters. How would you like to receive these Periodically this school will send you school related information Periodically this school will send you school related information Cell #: D Cell It: EJ Work#: D Work#: contact number: contact number: primary daytime primary daytime Employer: Employer: Circle one - Father, Mother, Step-Father, Step-Mother, Guardian, Foster Circle one - Father, Mother, Step-Father, Step-Mother, Guardian, Foster Relationship: Relationship: Is there a custody order in place? El NO El YES (If yes, please provide a copy ta the Student is living with: Q Both Parents Q Mother Q Father Q Guardian Q Foster Care PARENT? GUARDIAN INFORMATION Home Phone: Student s Cell phone: Mailing Address: Box #: Town: Postal Code: Land Location: Quarter Section Township Range Meridian Street Address: Date of Birth: 0 Male 0 Female 0 Month Day Year Unspecified Grade: @fl STUDENT REGISTRATION School:

SIBLING INFORMATION List any siblings / step-siblings (both older and younger): Grade: Birthdate: Grade: Birthdate: Grade: Birthdate: Grade: Birthdate: ANCESTRY INFORMATION Aboriginal people are orlnuit/inuk. those who identify themselves to be First Nations (Registered/Treaty/Status Indian, Non-Status Indian), Metis Based on this definition, do you consider yourself to be an Aboriginal person? QYES PROVINCIAL: Which group do you belong to: Q Registered/Treaty/Status Indian Q Q Non-status Indian 0 Metis Q NO Inuit/Inuk I reside: QOn Reserve QOff Reserve FEDERAL: Band of Residence: Reserve of Residence: Band of Financial Responsibility: LANGUAGE! ENROLMENT SK Resident: (No Tuition Status) Non-SK Resident: 0 Q Q I CITIZENSHIP YES (ASK resident is someone who owns, rents or leases a residence in SK or resides with an immediate family member who is a SK resident) Reciprocal Exchange Student Foreign Tuition (The student is NOT a resident of SK & NOT residing with an immediate family member) Province/Country of Birth: Citizenship: 1st Language spoken: 2nd Language spoken: IMMIGRATION STATUS Date of entry into Canada: Date of entry into Saskatchewan: o Permanent Resident (granted permission to live and work in Canada without any time limit on the stay, not yet a Canadian Citizen) QTemporary Resident (has came to Canada legally fora temporary purpose and does not have Canadian citizenship) o Student/Visitor Visa (A person who is lawfully in Canada for a temporary purpose such as work/study/visit & is not a Canadian citizen) o Refugee (seeking protection from former country) TRANSPORTATION INFORMATION Transportation is providedfor students residing within the from school. Is this that a NEW Student will BILLET INFO student registration: come to school QYES by bus: Q YES QNO 0 attendance area of a school NO If yes, bus driver s name: and who live more than one (1) kilometer RURAL STUDENTS: (in case the buses do not run due to weather, bus failure or emergency, we require a billet home in town for your child). Billet Phone/Cell #(s)

POLICY ON USE OF COMPUTER TECHNOLOGY Name of last school attended: Town/City: Grade: I give permission to have my child s Cumulative Records and Special Education files released from the forwarding School Division. Q YES Q NO Route: Bus: Driver: Stop: 0 Entered in VT 0 Family Informed Q Driver Informed 0 School Informed I IlTiE1.1 ] T.]1 11T1.T b Q Certificate of Permanent Residence (PR Card) [ cumulative r Q Passport (Photo page & visa) or Immigration Document Documents gathered: Q Birth certificate I.] ( 1 [ 1..1 hi i I Parent/Guardian Signature: Date: inform the school of any changes to the information contained on this form. that the information I have provided on this Registration Form is correct. I understand it is my responsibility to QYES ONO QNot applicable choose not to consent you may not be made aware of route cancellations that happen on short notice. o YES 0 NO Q Not applicable QYES ONO QNotapplicable TRANSPORTATION CONSENT layout. Q YES Q NO communication-supported student learning. It is understood that picture identification by name/reference will not be part of the webpage exclusively for the promotion of education which includes the school website, school newsletter, local newspaper, media and other the Ministry of Education & Kelsey Trail Health Region. FREEDOM OF INFORMATION & PROTECTION OF PRIVACY Q YES Q NO Student Signature: further evidence of my willingness to abide by the conditions of use as set out in the policy. that I shall use the technology in accordance with the Board of Education policy. I shall provide the signature of my parent or guardian as I understand and agree to follow the policy on use of computer technology in the North East School Division, I sign my name as a guarantee You may read the full policy here: This personal information collected under the authority of the Saskatchewan Freedom of Information and Protection of PrivacyAct will be held securely and in confidence, and will only be used in data collection software within the School Division and reported to I give permission to the school to take photos of my child. I give this release on the understanding that the materials produced will be used I have read, understood and agree to follow the School Bus Safety Notice within the North East School Division. You may read the full policy here: http://www.nesd.ca/programs/transportation/documents/driver%20-%zoschool%2obus%2osafetv%208x11.pdf I consent to medical information being given to the bus driver so that they are aware of any special needs or requirements. I consent to my name and telephone number(s) being included on a call list circulated to other families on the bus route. If you I hereby declare that I have read and understood the information contained in the above Permissions Section and Retain copies in student s record Q Original or translated transcripts / recording document from former school c NEW STUDENTS: EDUCATIONAL RECORDS PERMISSIONS

,.._ Tisdale Middle & Secondary School / Library Box 1000, 800 101 Street Tisdale, SK SOE ito tmss@nesd.ca http://tmss.nesd.ca 306-873-2352 Tisdale Community Library - Box 2499 800-101st St Tisdale SOE ito https://www.facebook.com/tisdalecommunjtyljbrar-q/ https://waitihbranj.ca/ 306-873-4767 145 12th Street East Prince Albert SK 56V 187 Phone: 306-764-0712 Fax: 306-922-1516 Email: wapiti @wapitilibrary.ca weiw.wapitilibrary.ca Wapiti Regional Library Serving Central Saskatchewan Dear Parent/Guardian: Library Card Application Form By completing and signing this form, you give your student permission to be registered for a Wapiti Regional Library card. You also agree to the following on behalf of yourself and the student: I agree to be responsible for all materials borrowed and other use of this card, and to pay any resulting fees or chagres from late, damaged, or lost items I agree to abide by Wapiti Regional Library and SILS (Saskatchewan Information Library Services) policies If this card is lost or stolen, I will report it immediately I authorize SILS to retain and use any personal information necessary for the provision of library services and I will ensure this information is accurate and up-to-date. To complete registration, you will also need to visit the library in-person to provide proof of your ID and address. Please bring the following: Proof of Address: Driver s ID, Utility bill or other government mail that show address, or letter/envelope/postcard sent with cancelled postage Proof of ID: Driver s ID, Passport, Student card, Military ID, SK Health card, Status card Until registration is completed, the student iiii be limited to checking out 4 items at a time. Your contact information will only be used for the purpose of contacting you about your library account such as notifications of items almost due, items overdue, or charges added to your account for overdue/missing/damaged items. For more information on Wapiti Regional Library s policies, services, and programs, please contact Tisdale Community Library. Student Name (Last, First) Student Date of Birth Parent/Guardian Name (Last, First) Parent/Guardian Email Parent/Guardian Mailing Address Parent Guardian Phone: Cell: Home: Work: I prefer to receive notifications about my library account via: TEXT (Provider) EMAIL PHONE CALL I grant permission for to be registered as a Wapiti Regional Library patron and accept responsibility for the items they check out. I agree to pay any fines resulting from overdue, damaged, or lost items, and acknowledge that borrowing privileges will be removed if the library account has $10.00 or more fines or fees on it. Parent/Guardian Name (Last, First) Parent/Guardian Signature

Please Print STUDENT INFORMATION I for students not enrolled in the school November 2017 but accessible location in the event of an audit. This form must be kept on file at the schoolfor a minimum offive years in a secure student.records@gov.sk.ca before accessing the student s information. Signature under 18 years of age and not present) Student or parent/guardian (if student is Signature LI determining secondary level programming (Gr. 10-12) LI other reason (explain briefly) for the purpose of: LI up to February 28 LI up to November30 LI up to June 30 LI up to September 30 LI up to April 30 (check the appropriate box below and initial in the blank) School Year to access my academic record in the Student Data System during the school year School/Institution Name Permission is granted to: First Name Middle Name Last Name IL Birthdate Learning ID Day Year Month f Initial Initial mitral Initial Irritral Month Year Day Month Year If consent cannot be obtained, please contact Student and Educator Services at Guidance counsellor to Access Student Information of - - Government Saskatchewan Authorization for Guidance Counsellors I_Form3

Sun Mon Tues Wed Thurs Fri July 2018 August 2018 2018-19 School Year Website: http://tmss.nesd. ca E-mail: tmss@nesd.ca Toll Free: 1-888-752-5741 Toll Free 1-888-884-0240 Fax: 306-873-2941 PH: 306-752-5741 Transportation Services: 306-873-4555 PH: 306-873-2352 Melfort, SK S0E lao Website: www.nesilca Tisdale, SK SUE 1 TO liox 1000, 800-101 Street September 2018 G Last 20 27 13 6 April 2019 T=21 S=20 24 17 23 10 3 2 16 9 I - T=15 S=15 First day of school Day of school School Admin - NC I Convention - NC SIP - NC Evening Student-Led Conferences Day 1 Day 2 T=]6 S=16 T=22 S=21 26 12 19 25 18 5 4 11 May 2019 27 28 30 31 20 22 2]2426 13 14 16[T 18 19 61 8[9j10[j12 I 3;4 5 January 2019 February 2019 T=22 S=21 T=20 S=20 28 30 25 21 22L23]2426 27 18 24 14 16R171 18 20 7 8 9J_10_[J 12 13 L 10 12J3[45 6 11 17 3 October 2018 November 2018 T=0 S=O 29 30 31 26 27 28303i 22 23 24 25 26 27 28 15 16 17 18 19 20 21 12 13 14 15 16 17 18 19 20 21 22 23 24 25 8 9 10 11 12 13 14 5 6 7 8 9 10 11 2 3 4 5 6 7 1234 Box 6000, 402 Main Street Fax: 306-752-1933 North East School Division #200 Tisdale Middle Secondary School NC No Classes 30 T=21 S=19 23 25 7 29 16 1719 2021 22 2 3 8 9 1113L1415 June2019 31 T=21 S=21 24 25N12729 30 10 1113 1516 17 19 21 Z2l 23 357 9 2 March 2019 30 23 16 22 29 9 15 2 8 December2018 30 T=19 S=19 23 24 26 28 16 i171 18 20 22 29 9 10 Iii 12 14 15 2I3I6 8 1 1 No School NESO Holiday istat Holiday T=194 S186 1 Sat