Cybersecurity & Artificial Intelligence Application

This program is for students entering Grade 12 in September, 2024.

If there are spots open, applications by students in Grade 10 & 11 will be reviewed

For the 2024-2025 school year

"*" indicates required fields

Participant Information

Name*

First Last

Male/Female/Other*

Grade in September 2024*

Date of Birth*

Student's Email*

Primary Parent Contact Information

Primary Parent Name*

First Last

Primary Contact Telephone*

Primary Contact Email*

Primary Contact Work Phone

Primary Contact Home Phone

Primary Contact Cell Phone

Primary Contact Address*

Street Address City Postal Code

Other Parent Contact Information

Other Parent Name

First Last

Other Parent Telephone

Other Parent Email

Other Parent Work Phone

Other Parent Home Phone

Other Parent Cell Phone

Other Parent Address if different from above

Street Address City Postal Code

Additional Information

Student's Current School*

School Location*

ie: West Vancouver, North Vancouver, etc.

School Attending this upcoming September*

Are you enroling in any of the following programs?

Other Specialty Program (i.e. FAST, YELL, YTT, etc)

Please list the program name if "Other" selected above

Please tell us why you would be a good candidate for this course. Please note that this course does require consistent attendance, self-study, strong work habits, and the ability to work both independently and cooperatively as part of a team. Explain what you hope to gain by participating in the program.*

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*Please note: multiple additional documents can be uploaded

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