Enrichment Survey for Students Feb 2010
 

1. Default Section

 

1. Date:

 MonthDayYear
What is the date you are completing this survey?

2. School:

 Schools
Which high school are you attending?

3. Name:

4. Birthdate

 MonthDayYear
When is your birthday?

5. Do you have an I.E.P (Individualized Education Plan) in place?

6. Grade:

 Grade
What grade are you in?

7. If you would like updates via email, please fill in your email address in the space provided.

8. Who is your homeroom teacher this semester?

9. Are you working on a post secondary (university or college) credit this semester:

 reply
WISE
A.P.
Other

10. If you checked "other" in the previous question, please elaborate in the space provided.

11. Are you working on extra credit work? If so indicate what you are working on.

 reply
Math module
Science module
English module
Science fair module
Independent Study full credit
Other

12. If you checked "other" in the previous question, please elaborate in the space provided.

13. Please indicate enrichment activities provided by classroom teachers during your first semester (ie. alternative assignments, pre-testing, science fair, competitions, etc.)

14. List any enrichment opportunities you were involved in first semester. These may have been provided by Enrichment program (ie. Junk Yard Wars at LCCVI, University of Waterloo trip, RISK at CKSS, LKCS Olympics, Culturas at NLSS, Queen Charlotte Island exchange at SCITS, "Two days in Toronto" through St. Clair, planning committees etc.)
Also list opportunities that you participated in that were offered through other school groups or self directed activities.

15. Are you interested in getting more information about any of the following?

 reply
Queens University e=mc2 program (1 week program at university usually held in May. Secondary students take a 5 day course in one of a variety of subjects. The cost is approximately $500 plus transportation)
Guelph Interactions program (1 day conference at university usually held in April)
Waterloo Unlimited program (3-5 day program, grade specific)
Shad Valley (1 month long summer program for 16-19 year old students. Programs are held at 12 different university campuses. The program emphasizes science, technology and entrepreneurship. Last applications in January)
Ontario Science Centre School (semester in Toronto. Applications are due in April; 4 credits granted)
Deep River Science Academy (summer, 2 high school credits)
Encounters with Canada (1 week, Ottawa, various theme weeks for students from across Canada. Applications through Guidance office or online)
Local engineering competitions (a saturday in Feb, sponsored by the Professional Engineering Society)

16. The next set of applications for Exchanges Canada is due on March 31, 2010. While an application does not guarantee a match, I am interested in knowing if there are enough students from your school who are interested in participating. Students from another province would come here for 1 week, we would go there for one week. Heritage Canada covers the transportation costs.

17. I am trying to organize an enrichment trip to China for 13 days over the March break in 2011. Before seeking final approval for this trip, I need to find out if there is enough interest. Please indicate what level of interest you have for such a trip.

18. If there is anything that you would like to suggest regarding future enrichment opportunities, please respond in space provided.

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