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? Student Parent/Guardian What is your residency status? Local B.C. Student International Student Which program are you applying for? Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 ELL English Language Learner Course Mark Upgrade Adult Student Options Please 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-time Full-time Caller name (who you are speaking with)* Student name First name Last name Student's first and last name First name Last name Student birth dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(mm/dd/yyyy)Student's birth dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(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/Family iLearn Staff Member Google / Online Social Media (FB/IG/TW/LI) Newspaper Partner Program Other Why 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? 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