Application – First Nations Regional Adult Education Center

Application to register at FNRAEC

Student Application Form

Choose location?

Applicants Legal Name (Legal First Name as it appears on the Birth Certificate)

Applicants Legal Name (Legal Last Name as it appears on the Birth Certificate )

Date of Birth (eg; January 5,2002)

Month/Day/Year

Gender (eg: Male, Female, Non-Binary)

Permanent Code:

(If you do not have your transcript, you can request it on the following website: https://www.quebec.ca/education/prescolaire-primaire-et-secondaire/epreuves-ministerielles-evaluation-apprentissages/demande-releve-diplome-secondaire)

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone

Registered Band/Community

Indian Status Number

Choose for my

Language (Mother Tongue)

English

Second – Language

French

Third – Language

Other

Parents Legal Names (as it appears on their Birth Certificates)

Parent 1

First

Last

Parent 2

First

Last

Emergency Contact Name

First & Last

Emergency Contact Phone Number

I consent for FNRAEC to consult my school records/transcripts

I agree

I do not agree

I certify that all the information provided is accurate to the best of my knowledge. I understand that the contact information I have submitted is essential to complete my registration, and I am responsible for updating it if any changes occur.

I agree
I do not agree