ADMIN ONLY - Eligibility Check - iLearn Secondary School

Notes

General notes for caller

Who is filling out this online form?

What is your residency status?

Which program are you applying for?

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.

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 date

(mm/dd/yyyy)

Student's birth date

(mm/dd/yyyy)

Where is the student currently enrolled?

Caller's email*

Caller's phone number

How did you hear about us?

Why do you want to take online courses?

Why does the student want to take online courses?

Address

Country