Accessibility Services - CollegeBound Registration Form ( Haileybury)
First Name:_______________________________
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Referenced from: CollegeBound: A Post-Secondary Transitional Program
Document text
Accessibility Services - CollegeBound Registration Form ( Haileybury)
First Name:_______________________________
Last Name:_______________________________
Preferred Name:__________________________
Cell Phone:_______________________________
Address: _________________________________
Email:____________________________________
City:_____________________
Province:__________________
Postal Code:__________________
Current School (if applicable):
______________________________________________________________
Program/Area of Study at Northern College (if applicable):_____________________________________
Please submit any accessibility support documentation (e.g PsychEd Assessment, IEP , or medical documentation) with this application, if you are submitting via email.
Documentation to follow.
Documentation is attached.
Please list any accommodations you require:
______________________________________________
I understand that the deadline to apply for Collegebound is Thursday, August 21 th, 2025.
Emergency Contact Information
Emergency Contact:_________________________
Relationship: _____________________________
Telephone:_________________________________
Alt. Telephone:____________________________
I have read the information on this form, and by signing, I agree to the terms outlined above.
_________________________________________________
Your confirmation can be submitted in person, or by email .
Email:
wigginst @northern.on.ca
Please contact us if you require this form in an alternative format.
Source: https://www.northerncollege.ca/uploads/2025/07/CollegeBound-Haileybury.pdf