ADMIN ONLY – Eligibility Check 6225 136 Street, Surrey, BC, Canada 604-590-5504 Contact Us NotesGeneral notes for caller Who is filling out this online form?StudentParent/GuardianWhat is your residency status?Local B.C. StudentInternational StudentWhich program are you applying for?Grade 8Grade 9Grade 10Grade 11Grade 12ELL English Language LearnerCourse Mark UpgradeAdult Student OptionsPlease type your desired course names below:Part-time or full-time?Choose whether you will take all your courses at iLearn or only select courses.Part-timeFull-timeCaller name (who you are speaking with)*Student name First name Last name Student's first and last name First name Last name Student birth dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(mm/dd/yyyy)Student's birth dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(mm/dd/yyyy)Where is the student currently enrolled?Where is the student currently enrolled?Caller's email* Caller's phone numberHow did you hear about us?Friend/FamilyiLearn Staff MemberGoogle / OnlineSocial Media (FB/IG/TW/LI)NewspaperPartner ProgramOtherWhy do you want to take online courses? Schedule flexibility Interest in specific courses Learn English Summer school options COVID-19 related reasons Retake a course / improve course mark / earn diploma Not satisfied with current education program Not satisfied with current school environment Other Why does the student want to take online courses? Schedule flexibility Interest in specific courses Learn English Summer school options COVID-19 related reasons Retake a course / improve course mark / earn diploma Not satisfied with current education program Not satisfied with current school environment Other